Objective To investigate the prevalence of hepatitis viruses in the Department of Gastroenterology in the 5th medical center of the PLA general hospital and to provide a reference for the clinical treatment. Methods 228 patients, who were admitted to the Department of Gastroenterology of our hospital due to various liver diseases, were enrolled in the study from January, 2012 to December, 2017. All patients were tested for the presence of DNA/RNA, antigens, and antibodies of hepatitis viruses. Results Among 228 patients, 12.72% (29/228), 2.63% (6/228), 0.88% (2/228), and 0.44% (1/228) were HBsAg positive, anti-HCV positive, HEV RNA positive, and HGV RNA positive, respectively. No HAV and HDV infections were detected in these patients. Mixed infections were only found in 1 patient (HBV/HEV). Among 89.66% (26/29) of HBsAg-positive patients, 84.62% (22/26) were HBV DNA positive and the corresponding median viral load was 5.50×105 IU/mL (IQR, 1×103-1.89×106). Among 66.67% (4/6) of anti-HCV-positive patients, only 1 patient was HCV RNA positive and the corresponding viral load was 2.56×106 IU/mL. Conclusion The dominant hepatitis viruses in the Department of Gastroenterology of our hospital are mainly HBV, followed by HCV. HEV and HGV infections are rarely detected. No HAV and HDV infections are detected in the current study.

Objective To determine levels for the free carnitine and acylcarnitines in dry blood spots of preterm，full term and postterm infants from Henan province, and to establish their reference intervals respectively. Methods A total of 63,799 newborns born in Henan Province from January, 2015 to June, 2019 were enrolled as the study subjects. According to the gestational age at birth, they were divided into the preterm infant group (n = 10 034), the full term infant group (n = 51 307) and the postterm infant group (n = 2 458). The levels of free carnitine and acylcarnitine were tested by Tandem mass spectrometry, and the reference intervals were established on the basis of gestational age at birth. Results The levels of free carnitine and acylcarnitines except for C4 had statistical differences between full term and preterm infants (P <0.05). The levels of acylcarnitine in full term infants were significantly higher than those in postterm infants (P <0.05). Except for C2, C3DC / C4OH, C6, C10, C14 and C18, the levels of free carnitine and acylcarnitine were significantly different between preterm and postterm infants (P <0.05). The reference intervals of newborns were established according to different gestational age. Conclusions The reference intervals of free carnitine and acylcarnitine for preterm infants, postterm infants and full-term infants in Henan Province are established respectively, which can be used as the reference basis for screening and diagnosing disorders of fatty acid and organic acid metabolism of newborns in Henan province.

Objective By analyzing the antinuclear antibody and antinuclear antibody spectrum of bacterial pneumonia patients in respiratory department of Peking University Shougang Hospital，to investigate the clinical value of detecting the antinuclear antibody and antinuclear antibody spectra among bacterial pneumonia patients. Methods The research objects were 360 inpatients with bacterial pneumonia in the respiratory department of Peking University Shougang Hospital from June, 2018 to December, 2018. The indirect immunofluorescence method was used to detect the antinuclear antibodies with the serum of the patients. Western blotting was used to detect the serum antinuclear antibody spectrum. Results There were 121 positive antinuclear antibody in 360 patients with bacterial pneumonia, accounted for 33.61%, and 9 positive patients were diagnosed as autoimmune disease, accounted for 7.44%. Because the patient didn't cooperate with the examination, 7 patients were considered as suspected autoimmune diseases, accounted for 5.78%. In patients with positive antinuclear antibody, there were 41 patients with positive antinuclear antibody spectrum. In 9 patients with autoimmune disease，8 cases were positive and 1 cases were negative for antinuclear antibody spectrum. Conclusions Patients with bacterial pneumonia hospitalized in respiratory department should be screened for antinuclear antibody and antinuclear antibody spectrum to prevent the missing diagnosis of autoimmune diseases.

Objective To investigate the correlations between serum D-dimer and total bilirubin levels and senile schizophrenia. Methods 130 elderly patients with schizophrenia treated in the hospital between January, 2016 and June, 2019 were selected for the case group, and they were treated with antipsychotics. Meanwhile, 100 elderly healthy people were selected as the healthy control group. Serum D-dimer and total bilirubin levels in the case group were compared before and after the treatment and compared between groups. The Positive and Negative Syndrome Scale (PANSS) scores before and after the treatment were recorded. The prognosis of patients was evaluated with the gross assessment scale (GAS) during 6-month of follow-up after discharge. Pearson correlation analysis and logistic analysis were performed. Results Serum D-dimer levels in the case group before the treatment were higher than those in the control group (P<0.05), and serum total bilirubin levels were lower than the control group (P<0.05). Serum D-dimer and total bilirubin levels as well as PANSS scores were decreased after the treatment (P<0.05). The difference values of serum D-dimer and total bilirubin levels before and after the treatment were positively correlated with the difference values of PANSS scores (P<0.05). There were 97 patients with good prognosis and 33 patients with poor prognosis. Serum D-dimer levels (β = 0.615, OR = 1.850, 95% CI = 1.131-3.025) and serum total bilirubin levels (β = 0.624, OR = 1.528, 95% CI = 1.168-1.999) were important factors affecting the prognosis of patients. Conclusion Serum D-dimer levels are relatively high and total bilirubin levels are relatively low in elderly patients with schizophrenia. After the treatment with antipsychotics, serum D-dimer and total bilirubin levels are significantly related to the relief of psychiatric symptoms and they are important factors influencing the prognosis of patients.

Objective To comprehensively assess the diagnostic efficacy of circular RNA (circRNA) expression pattern in confirmed hepatocellular carcinoma (HCC), so to provide the evidence for the early detection of HCC. Methods The online databases including PubMed, EMBASE, and CNKI were searched for eligible studies. Two investigators were arranged to screen literatures and extract the data independently. The diagnostic effects were combined using STATA 12.0 software after an evaluation of the risk and bias among all enrolled studies. Subgroup study, sensitivity analysis and meta-regression test were applied to fully assess the potential sources of study heterogeneity. Results A total of 11 eligible studies were included, comprising 880 HCC cases. Results of the meta-analysis showed that circRNAs harbored a combined sensitivity of 0.75 (95%CI：0.73-0.78), specificity of 0.78 (95%CI: 0.75-0.81), and AUC (area under the curve) of 0.86 in differentiating HCC cases from non-cancer controls. Subgroup study showed that tissue-sourced circRNA testing achieved higher performance in detecting HCC than plasma-sourced circRNAs (AUC: 0.89 vs. 0.74); also the detection of circRNAs expression yielded higher diagnostic value in differentiating HCC from non-cancer controls than the efficacy in differentiating HCC from hepatitis/cirrhosis (AUC: 0.89 vs. 0.74); and elevated circRNAs showed an efficacy superior to down-regulated circRNAs in confirming HCC (AUC: 0.90 vs. 0.81). Conclusions CircRNAs can be considered as promising molecular biomarkers to aid the diagnosis of HCC.

Objective To explore levels of serum Cystatin C (Cys C) , neutrophil gelatinase-associated lipoprotein (NGAL) and microalbuminuria/creatinine ratio (ACR) in patients with diabetic nephropathy (DN) and their clinical significances. Methods T2DM inpatients in the hospital from June, 2015 to May, 2019 and 100 healthy adults were enrolled for the study. T2DM patients were divided into DN group and simple T2DM group. The levels of serum Cys C, creatinine (Scr) and NGAL, as well as glomerular filtration rate (GFR) in all groups were measured. Results ①The levels of serum NGAL, Scr, ACR and CysC in DN group were significantly higher than those in T2DM group and the control group, while GFR was lower than that in T2DM group and the control group (P<0.05). There were no significant differences in serum NGAL, Scr or GFR between T2DM group and the control group (P>0.05). ②Pearson correlation analysis showed that serum NGAL and CysC levels were positively correlated with ACR (P<0.05), while negatively correlated with GFR (P<0.05). ③The areas under curves (AUC) of serum Cys C, NGAL , Scr and ACR for the diagnosis of DN were 0.788, 0.874 , 0.701 and 0.940, respectively. Among them, the diagnostic value of serum NGAL was the highest. The areas under the curve of serum Cys C, NGAL, or Scr combined with ACR for the diagnosis of DN were 0.950, 0.960, and 0.946, in which NGAL combined with ACR had the highest diagnostic efficiency. Conclusion DN patients may be accompanied with increase of serum CysC and NGAL levels, which are related with renal function indexes such as ACR and GFR. Clinically, these markers can be applied for the early diagnosis and disease assessment of DN.

Objective To investigate the relationship between C-reactive protein (CRP), fibrinogen (Fib), platelet/lymphocyte ratio (PLR) and survival prognosis in patients with postoperative laryngeal cancer. Method We collected 170 patients with laryngeal cancer who were admitted to our department from January, 2010 to December, 2013 for the study. CRP, Fib, and PLR values were measured 3 days before the surgery. According to the levels of these three markers, these patients were divided into the CRP low level group (n=73) and CRP high level group (n=97), the Fib low level group (n=75) and Fib high level group (n=95), the PLR low level group (n =78) and PLR high level group (n=92), respectively. The differences in CRP, Fib, and PLR levels between preoperative and postoperative groups were compared, so to evaluate the relationship between CRP, Fib, PLR and clinicopathological features of patients with laryngeal cancer, as well as to determin the effect of changes of CRP, Fib and PLR on survival prognosis of postoperative patients with laryngeal cancer. Results The levels of CRP, Fib and PLR in the low-level group of patients with laryngeal cancer were lower than those in the high-level group (all P<0.05). The CRP, Fib and PLR values of preoperative patients with laryngeal cancer were lower than those of preoperative patients (all P<0.05). After 60 months of follow-up, the survival rates of the low-level CRP, Fib, and PLR groups (78.08%, 80.00%, and 80.76%) were significantly higher than those of the high-level groups (57.73%, 61.33%, and 60.87%) (all P<0.05). Multivariate analysis showed that poor tumor differentiation, lymph node metastasis, tumor recurrence, elevated CRP, Fib and PLR levels were independent risk factors for the prognosis of patients with laryngeal cancer. Conclusion The elevated levels of CRP, Fib and PLR are independent risk factors for patients with laryngeal cancer. They have certain clinical values in evaluating the survival prognosis of patients with laryngeal cancer.

Objective To analyze the drug resistance and genotypes of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamases (ESBLs) in patients with respiratory tract infection in the hospital. Methods 598 strains of Escherichia coli and Klebsiella pneumoniae isolated from sputum culture specimens of patients with respiratory tract infection who were admitted to the hospital between May, 2017 and June, 2018 were selected as study samples. ESBLs strains and drug resistance were detected, and 50 ESBLs strains were subjected to drug resistance genotyping. Results 234 strains producing ESBLs were detected in 598 strains of Escherichia coli and Klebsiella pneumoniae, and the detection rate was 39.13%. The detection rates of Escherichia coli and Klebsiella pneumoniae were 53.09% and 29.57%, respectively. The sensitivity of Escherichia coli producing ESBLs to imipenem was the highest, while the sensitivities to piperacillin and cefazolin were the lowest. The sensitivity of Klebsiella pneumoniae producing ESBLs to imipenem was the highest, and the sensitivities to piperacillin and cotrimoxazole were the lowest. Except for imipenem and gentamicin, sensitivities of Escherichia coli and Klebsiella pneumoniae producing ESBLs to other types of antibiotics were significantly lower than those of non-ESBLs strains. Among 50 strains of ESBLs strains for genotyping, the detection rate of CTX-M-13 strains was the highest (90.00%), followed by TEM (80.00%). 46 strains (92.00%) of bacteria carried multiple genotypes. Conclusion The detection rates of Escherichia coli and Klebsiella pneumoniae producing ESBLs in the hospital are high, which is characterized by multiple antibiotic resistances, and there are many drug resistance genes in these strains. For clinical treatment, it is advisable to choose drugs such as imipenem and β-lactamase inhibitor compound preparations, and the monitoring system of drug-resistant bacteria should also be strengthened.

Objective To explore the changes and clinical significance of serum γ-glutamyltransferase (γ-GT), globulin (GLB), albumin (ALB), total cholesterol (CHOL) and alpha-fetoprotein (AFP) levels in patients with hepatocellular carcinoma. Methods The clinical data of 86 patients with primary hepatocellular carcinoma (PHC) (the PHC group) admitted from January, 2014 to June, 2016 were retrospectively analyzed, and 40 patients with cirrhosis (the cirrhosis group) and 30 healthy examiners (the control group) were included as controls. The levels of γ-GT, GLB, ALB, CHOL and AFP in each group were measured and compared among groups. The levels of γ-GT, GLB, ALB, CHOL and AFP were evaluated among patients with different liver function (Child-Pugh). ROC curve was drawn to evaluate the efficacy of single detection and combined detection of indicators on PHC. The prognosis was recorded. The relationship between each indicator and patient survival time was evaluated. Results The levels of γ-GT, GLB and AFP were higher than those in the control group (P<0.05), while the levels of CHOL and ALB in the PHC group and cirrhosis group were lower than those in the control group (P<0.05), and the levels of γ-GT, GLB and AFP in the PHC group were higher than those in the cirrhosis group (P<0.05), while the level of CHOL in the PHC group was lower than that in the cirrhosis group (P<0.05), and there was no significant difference in the ALB between the PHC group and cirrhosis group (P>0.05). The levels of γ-GT, GLB and AFP of patients with Child-Pugh grade A and Child-Pugh grade B were lower than those of patients with Child-Pugh grade C (P<0.05), while the levels of CHOL and ALB of patients with Child-Pugh grade A and Child-Pugh grade B were higher than those of patients with Child-Pugh grade C (P<0.05). The highest AUC of each indicator for the diagnosis of PHC was AFP. The AUC of combined diagnosis was higher than that of each individual indicator. The survival time of PHC Ⅲ stage patients with normal γ-GT, GLB, AFP and ALB was longer than that of abnormal patients (P<0.05), and there was no significant difference in the survival time between patients with normal and abnormal CHOL (P>0.05). The survival time of PHC IV stage patients with normal γ-GT, GLB and AFP was longer than that of abnormal patients (P<0.05), and there was no significant difference in the survival time between patients with normal and abnormal CHOL and ALB (P>0.05). Conclusion The levels of γ-GT, GLB and AFP are increased, while the levels of CHOL and ALB are decreased in patients with hepatocellular carcinoma. The detection of serum markers is beneficial to the differential diagnosis and prognosis of PHC patients.

Objective To investigate the relationships between PCT, CRP and child-Pugh grade in patients with hepatitis B cirrhosis. Methods We randomly selected 97 patients with hepatitis B cirrhosis (the cirrhosis Group) and 30 patients with hepatitis (the control group) and compared their levels of PCT and CRP. We also analyzed the PCT and CRP levels within patients with hepatitis B cirrhosis according with the triple-positive of HBsAg, HBeAg, and HBcAb, as well as the triple-positive of HBsAg, HBeAb, and HBcAb. Results (1)The level of PCT and CRP in the cirrhosis group were significantly higher than those in the control group (P＜0.05) and there was no difference in age (P＞0.05). (2)There was a significant difference between PCT and CRP among child-Pugh grades A, B and C (P＜0.05). There was a significant difference in PCT and CRP between Grade A and grade C (P＜0.05). (3)There was no significant difference of PCT and CRP results between the triple-positive of HBsAg, HBeAg, and HBcAb and the triple-positive of HBsAg, HBeAb, and HBcAb in liver cirrhosis (P＞0.05). There was no significant difference in PCT and CRP between grade A and B or B and C or A and C. Conclusion The changes of PCT and CRP levels in patients with hepatitis B are related to Child-Pugh grading, but not related to the triple-positive of HBsAg, HBeAg, and HBcAb, as well as the triple-positive of HBsAg, HBeAb, and HBcAb in liver cirrhosis.

Objective To explore the value of fetal neck transparent (NT) thickness combined with maternal serum miR34a and miR-206 levels in the diagnosis of fetal congenital heart diseases (CHD) in early pregnancy. Methods A total of 63 pregnant women with CHD fetus diagnosed in Handan Maternity and Child Care Centers from January, 2016 to June, 2019 were enrolled as the case group, while 65 pregnant women with normal heart fetus were selected as the healthy group. Both groups of pregnant women were given ultrasound examination to measure NT thickness and underwent serum test to detect microRNA-34a (miR-34a) and microRNA-206 (miR-206) expression levels. Results There was no significant difference in general fetal data between two groups (P>0.05). The fetal NT thickness of the case group was significantly higher than that of the healthy group. The sensitivity, specificity and area under the curve (AUC) of NT thickness in the diagnosis of CHD were 84.13%, 78.46% and 0.823, respectively. The expression level of maternal serum miR-206 in the case group was also significantly higher than that of the healthy group. The sensitivity, specificity and AUC of miR-34a and miR-206 expression levels in the diagnosis of CHD were 55.56%, 86.15% and 0.752, respectively. The sensitivity, specificity and AUC of two methods combined in the diagnosis of CHD were 95.24%, 92.31% and 0.953, respectively. Conclusion Using ultrasound examination to measure fetus NT thickness and combine it with serum test to detect maternal miR-34a and miR-206 expression levels for the diagnosis of CHD in early pregnancy can be used to diagnose CHD and it improves the diagnostic accuracy.

Objective To summarize and analyze the clinical characteristics of differentiated thyroid cancer (DTC) with multiple primary carcinoma（MPC）, and to provide potential clinical diagnosis and treatment methods for DTC patients with MPC. Methods The clinical data of 1,140 DTC patients treated with 131I from January, 2014 to May, 2017 in our hospital were retrospectively analyzed. DTC and MPC were used as the retrieval conditions to search in the medical records query system. The clinical data were sorted and analyzed by using Warran's revised MPC diagnostic criteria. Results There were 28 cases of DTC with MPC, accounting for 2.46% (28 / 1140) of DTC in the same period. The ratio of men to women was 1: 6. The average age was 54.3 years. In DTC with MPC, the secondary cancer occurred in the breast with a maximum number of 15 cases, followed by 6 cases in the lung. Simultaneous MPC were 13 cases, and it was more common to see that DTC and breast cancer, kidney cancer, lung cancer occurred at the same time. Heterogeneous MPC was found in 15 cases with an average time interval of 6.52 years. When DTC was the primary cancer, the average time of finding the second primary carcinoma was 4.14 years. There were 12 cases, in which DTC was not the primary carcinoma, the average time of finding DTC was 7. 08 years. The average follow-up time was 40.9 months and all patients survived. Conclusion DTC with MPC has some unique clinical features. Attention should be paid to the occurrence of second primary cancer, also the early detection, early diagnosis and early treatment which can all help to improve prognosis and increase survival rate.

Objective To investigate the pathogenesis of hypertensive pregnancy complications by evaluating the activity of δ-aminolevulinic acid dehydratase (d-ALA-D) and classical oxidative stress markers. Methods According to the severity criteria, 90 pregnant women from the Department of Obstetrics and Gynecology in our hospital from February, 2016 to March, 2018 were selected for the study. Among them, 30 healthy pregnant women were in the control group (C), and 30 pregnant women were in the mild pre-eclampsia group (Mild, Pre-eclampsia, MPE), also 30 pregnant women were in the severe pre-eclampsia (SPE) group. Detections of oxidative stress markers, thiobarbituric acid reactive substances (TBARS), plasma proteins and non-protein thiol in blood of pregnant women with mild and severe pre-eclampsia were conducted by ultraviolet spectrophotometer, as well as vitamin c content. The detection of catalase and d-ALA-D activity in blood samples from pregnant women with pre-eclampsia was also performed. Protein expressions of four essential enzymes responsible for maintaining physiological ROS (reactive oxygen species) levels were measured by western blotting. Results  Systolic and diastolic blood pressures were higher in the pre-eclampsia group compared with the pregnancy control (P<0.05), and uric acid was higher in the SPE group (C group, 3.45±0.37 mg/dL; MPE group, 4.63±0.98 mg/ dL; SPE group, 5.97 ± 1.97 mg / dL, P <0.05). For proteinuria, the content of SPE group was significantly higher than that of MPE group (P <0.05). The levels of TBARS in the oxidative stress markers were significantly increased in the MPE and SPE groups (P<0.05), while for other oxidative stress markers such as the protein thiol group, the non-protein thiol group, vitamin C and catalase, the activities were significantly reduced (P < 0.05). Compared with the pregnancy control, the δ-Ala-D activities in the blood of the MPE group and the SPE group were significantly decreased (P<0.05), and the δ-ALA-D enzyme reactivation index was also higher. The relative levels of SOD1 in the MPE and SPE groups were significantly lower than those in the pregnant group (group C, 298.14±36.17; MPE group, 187.25±21.25; SPE group, 190.73±25.69; P<0.05), and catalase levels significantly decreased (group C, 64.33 ± 14.25; MPE group, 36.47 ± 6.78; SPE group, 39.17 ± 8.74; P < 0.05). Conclusion This study reports the level of oxidative stress in pregnant women with pre-eclampsia, highlights the correlation between d-ALA-D activity and other markers of oxidative stress in pregnant women with preeclampsia, explores the relationship between pre-eclampsia and antioxidant system in controlling uterine muscle. Our results will help to further explore the mechanism of oxidative stress involved in the disease.

Objective To compare the effects of two carbon and indocyanine green (ICG) fluorescence tracer methods on lymph node dissection and thyroid protection in thyroid carcinoma. Methods A total of 103 patients who underwent radical thyroidectomy in our Hospital from March, 2017 to January, 2019 were randomly divided into a nanocarbon group (53 cases) and an ICG group (50 cases). In the nanocarbon group, the nanocarbon suspension was injected into the thyroid tissue to guide the lymph node dissection. In the ICG group, the thyroid tissue was injected with the indocyanine green tracer to guide the lymph node dissection. The surgical indexes of the two groups were then compared to obtain the total number of lymph nodes, the number of lymph nodes of different sizes, the detection rate of lymph node metastasis, the detection rate of parathyroid, postoperative parathyroid hormone (PTH), calciumion (Ca2+) level, and temporary low calcium rate, as well as hemorrhage and transient hypoparathyroidism rate. The postoperative complications were recorded in both groups. Results There was no significant difference in the operation time, intraoperative blood loss, postoperative drainage, and postoperative hospital stay between the two patients (P>0.05). The number of lymph nodes in the nanocarbon group was higher than that in the ICG group, including the total number of acquired lymph nodes, the number of lymph node acquisitions less than 0.5cm, and the detection rate of lymph node metastasis (P<0.05). The detection rate of parathyroid gland and the incidence of transient hypocalcemia in the nanocarbon group were lower than those in the ICG group, and the postoperative PTH and Ca2+ levels were higher than those in the ICG group (P<0.05). There were no significant differences in complications such as recurrent laryngeal nerve injury, wound infection, subcutaneous hemorrhage/effusion and thoracic duct between the two groups (P>0.05). Conclusion Nanocarbon tracer can improve the degree of lymph node dissection in thyroid cancer surgery, and effectively protect the parathyroid gland from damage. It is a safe and reliable technique and worth promoting.

Objective To observe the expression and evaluate the clinical significance of serum amyloid A in patients with systemic lupus erythematosus. Methods Seventy-six patients with systemic lupus erythematosus were enrolled for the study. The patients were divided into the lupus active group (n=31) and the stable group (n=45) with active evaluation by systemic lupus erythematosus activity score (SLEDAI). A total of 55 healthy subjects (aged 24 to 66 years old) were selected as the control group. Serum SAA levels in each group were determined by immune scattering ratio turbidity method. Results The mean serum SAA level (9.07±4.68 mg/L) in 76 patients with SLE was significantly higher than that in the control group (3.03±0.83 mg/L) (P<0.05). The SAA concentration in patients with active SLE was 22.39±6.80 mg/L, which was significantly higher than that in patients with non-active SLE (5.36±1.57 mg/L) (P<0.05). There was a significant positive correlation between SLEDAI score and SAA level (R2=0.8671, P<0.05). There was no significant difference in serum SAA levels between the SLE stable group and healthy controls (P>0.05). The area under the ROC curve of SAA was 0.892. Serum SAA expression levels were positively correlated with 24-hour urine protein, ANA titer and anti-dsDNA antibody expression in SLE patients. Conclusion The expression level of SAA as an indicator of inflammation is elevated in SLE, which can be considered as a biomarker candidate cytokine as a predictor of disease activity in SLE patients, and provides a knowledge base for further study of the target of SLE individualized therapy.

Objective To explore relationships between changes in levels of serum pregnancy-associated plasma protein A (PAPP-A), plasma protein C (PC) and high-sensitivity C-reactive protein (hs-CRP) and coronary lesion degree, prognosis in patients with coronary heart disease (CHD). Methods The study cohort were 186 CHD patients (the disease group) who were admitted to the hospital from October, 2017 to October, 2018 and 85 healthy volunteers (the control group) who underwent physical examination during the same period. The levels of serum PAPP-A, PC and hs-CRP were compared between the two groups. Coronary angiography was conducted to evaluate coronary lesion degree among CHD patients. The prognosis in the disease group was followed up. The changes in levels of serum PAPP-A, PC and hs-CRP among CHD patients with different coronary lesions and prognosis were analyzed. And a correlation analysis was conducted. Results Compared with the healthy group, levels of serum PAPP-A and hs-CRP were significantly higher in the disease group, while PC level was significantly lower (P<0.05). With exacerbation of coronary lesions, levels of serum PAPP-A and hs-CRP among CHD patients were significantly increased, while level of PC was significantly decreased in turn (P<0.05). The follow-up results showed that there were 42 cases (22.58%) with MACE. The levels of serum PAPP-A and hs-CRP in CHD patients with MACE events were significantly higher than those without MACE events, while PC level was significantly lower than that without MACE events (P<0.05). Pearson correlation analysis found that coronary lesion degree and prognosis were significantly positively correlated with serum PAPP-A and hs-CRP (r=0.546, 0.607, P<0.05), while significantly negatively correlated with PC level (r=–0.512, P<0.05). Conclusion The levels of serum PAPP-A and hs-CRP are significantly increased, while PC is significantly decreased in CHD patients. The three are closely related to severity and prognosis of CHD, which can be applied as effective indexes for risk stratification and prognosis evaluation of CHD.

Objective To analyze the curative effect of snake injury ointment on Agkistrodon halys bite. Methods 100 patients with Agkistrodon halys bite in the Emergency Department of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine were collected for the study, including 20 cases in the control group, 40 cases in the Ji Desheng snake tablet external application group and 40 cases in the snake injury ointment external application group. The hematological indexes of all patients before and after the treatment were measured and compared, including aspartate aminotransferase (Aspartate transaminase,AST) and lactic dehydrogenase (Lactate dehydrogenase, LDH), α-hydroxybutyrate dehydrogenase (Alpha-hyd). The changes of roxy- butyrate dehydrogenase, HBDH), creatine kinase (Creatine kinase,CK) and creatine kinase isoenzyme (CreatineKinase-MB,CK-MB) were compared before and after the treatment. In addition, the results of limb swelling, pain score, swelling of affected limb and pain disappearance time were compared, and the average treatment time of each group was compared. Results Compared with before the treatment, AST, CK and CK-MB in the external application group of Jidesheng snake tablet decreased significantly (P < 0.05), while LDH and HBDH had no significant difference before and after the treatment. Compared with before the treatment, AST, LDH, HBDH, CK and CK-MB in the external application group decreased significantly (P < 0.05). Compared with before the treatment, the limb swelling and pain score of the patients after the treatment were significantly lower than those of the control group (P < 0.05). Compared with the control group, the limb swelling and pain score of the patients in the external application group and the snake injury ointment group were significantly better (P < 0.05). There was no significant difference in limb swelling and pain score between the external application group and the snake injury ointment group after the treatment (P > 0.05). Compared with the control group, the limb swelling, pain disappearance time and average treatment time of the patients in the external application group and the snake injury ointment group were significantly shorter (P < 0.05). There was no significant difference in limb swelling, pain disappearance time and average treatment time between the external application group and the snake injury ointment group after the treatment (P > 0.05). Conclusion External application of snake injury ointment and other therapies of integrated traditional Chinese and western medicine can effectively treat Agkistrodon halys bite.

Objective To investigate the relationship between the high mobility group histone B1 (HMGB1) and the clinical pathological features of patients with stage III rectal cancer and 3 years disease-free survival (DFS). Methods Forty-six patients with stage III rectal cancer after operation from February, 2011 to December, 2015 were enrolled for the study. Immunohistochemistry was used to detect the expression of HMGB1 protein. We then investigated the relationship between HMGB1 protein expression and clinicopathological features of patients with stage III rectal cancer, and analyzed the relationship between HMGB1 protein expression and 3 years DFS. Results HMGB1 was highly expressed in rectal cancer tissues in 24 cases, accounting for 52.2%, while in 10 cases, HMGB1 was highly expressed in adjacent tissues, accounting for 21.7%, with the significant difference (χ2=9.144，P=0.002). The expression of HMGB1 was not associated with age, gender, surgical procedure, presence of vascular tumor thrombus or neurological invasion, pT stage, preoperative CEA level, tumor growth type, but was associated with pN stage, tumor differentiation, and cancer nodules. Among the 46 patients, 22 patients relapsed 3 years after the surgery. The total DFS rate was 52.2%. Univariate analysis showed that HMGB1, degree of differentiation, vascular tumor thrombus or neurological invasion, preoperative CEA levels, and pN stage were associated with prognosis. Multivariate analysis showed that the degree of differentiation and preoperative CEA levels were independent prognostic factors. Conclusion The expression of HMGB1 is related to the stage of pN stage, the degree of tumor differentiation, and the presence of cancer nodules in stage III rectal cancer. High expression of HMGB1 may be an adverse factor affecting 3 years DFS in patients with stage III rectal cancer after the operation, but it is not significant enough as an independent prognostic factor. Testing HMGB1 can be informative for the prognosis.

Objective To establish the reference intervals of three thyroid biomarkers among early pregnancy women using the detection data contained in our hospital laboratory database. Methods The data of three thyroid biomarkers for 2,177 early pregnancy women in the obstetric outpatient clinic of our hospital were collected from May 1st, 2016 to Aprils 30th, 2017. After pre-processing, 1,994 cases were included for the study. The reference intervals were then established by the statistic processing. Results The reference intervals of three thyroid biomarkers for early pregnancy women were TSH 0.099-4.000 mIU/L, FT3 3.14-5.95 pmol/L, and FT4 11.27-21.11 pmol/L,?respectively. Conclusion To establish the reference intervals of three thyroid biomarkers among early pregnancy women using the indirect method is feasible.

Objective To observe curative effect of terbutaline combined with N-acetylcysteine on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the influence on immune function. Methods 60 patients with AECOPD in the hospital were enrolled for the study. They were randomly divided into three groups by the number table method, with 20 cases in each group. Patients in group A were treated with terbutaline, while group B were treated with N-acetylcysteine, and group C were treated with terbutaline combined with N-acetylcysteine. The oxidative stress response [superoxide dismutase (SOD), malondialdehyde (MDA)], lung function [forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), FEV1/FVC], immune function (CD3+, CD4+, CD4+/CD8+) and peripheral blood eosinophil (EOS) count were compared among the three groups before and after the treatment. The symptom improvement time and curative effect in all three groups were observed. Results The total effective rate of group C (100.00%) was significantly higher than that of group A (70.00%) and group B (65.00%) (P<0.05). After the treatment, SOD in group C was significantly higher than that in group A and group B (P<0.05), while MDA was significantly lower than group A and group B (P<0.05). After the treatment, FVC, FEV1, FEV1/FVC, CD3+, CD4+ and CD4+/CD8+ in group C were significantly higher than those in group A and group B, while EOS count was significantly smaller than that in group A or group B (P<0.05). The disappearance time of dyspnea and cough, improvement time of wheezing and disappearance time of wheezing rale in group C were significantly shorter than group A and group B (P<0.05). Conclusion Terbutaline combined with N-acetylcysteine can effectively improve immune function and lung function of AECOPD patients, also alleviate inflammation and oxidative stress response, promote clinical symptoms recovery, and achieve a good curative effect.

Objective To explore the correlation between serum magnesium level and arteriosclerosis, left ventricular function in patients with chronic kidney disease (CKD). Methods A total of 200 CKD patients who were hospitalized in the nephrology department of the hospital from January, 2017 to December, 2018 were divided into the CKD1 group (12 cases), CKD2 group (38 cases), CKD3 group (74 cases), CKD4 group (55 cases) and CKD5 group (21 cases). The general biochemical indexes, arteriosclerosis indexes and left ventricular function indexes were compared among all groups. The correlations between magnesium and indexes of patients in different stages were analyzed. Results ①With the increase of CKD staging, general biochemical indexes, including triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), serum phosphorus, magnesium, serum creatinine (Scr) and blood urea nitrogen (BUN) were increased in CKD patients, while the serum calcium were decreased. There was a significant difference in the level of serum magnesium ions among patients across groups (P <0.05): there was no significant difference in patients from CKD1 to CKD4 stage (P> 0.05), while the patients with CKD5 stage were significantly higher than other groups (P<0.05). ②The ankle-brachial index (ABI), Brachial-ankle Pulse Wave Velocity (baPWV) of patients across each group was significantly different (P<0.05), and there was no significant difference in other indicators (P>0.05). ③There was no significant correlation between serum magnesium concentration and arteriosclerosis indexes, cardiac function indexes in CKD patients at stage 1-3 (P>0.05). In CKD patients at stage 4-5, serum magnesium concentration was positively correlated with TBI, ABI, VE and VA of mitral valve (P<0.05). Conclusion Serum magnesium level is closely related to arteriosclerosis and left ventricular function in advanced CKD patients. An intervention of magnesium balance should be emphasized in clinical practice to reduce the incidence of related complications.

Objective To investigate the clinical value of serum copeptin (CPT) combined with uterine artery blood flow parameters for the early screening of preeclampsia (PE). Methods 504 pregnant women who had undergone pregnancy examination in our hospital from April, 2018 to May, 2019 were prospective randomly selected as the study objects. All pregnant women were then followed up until delivery. According to whether PE occurred during pregnancy, 38 pregnant women with PE were included in the PE group, and the rest 466 pregnant women were included in the control group. The levels of serum CPT were measured by enzyme-linked immunosorbent assay at 20-24 weeks of gestation. The pulsatility index (PI), systolic phase/diastolic phase (S/D) and resistance index (RI) were measured by color Doppler ultrasound. Results S/D, PI, RI and serum CPT of the PE group were significantly higher than those of the control group (P<0.05). Pearson analysis showed that serum CPT was positively correlated with diastolic pressure, systolic pressure, S/D, PI and RI of patients with PE (P<0.05). ROC curve analysis showed that serum CPT had a higher predictive value for PE, and the area under the curve was 0.797. The uterine artery blood flow parameters also had a higher predictive value for PE, among which PI had the highest predictive value, with the area under the curve 0.813. Serum CPT combined with PI could significantly improve the predictive value, with the sensitivity 84.21% and the specificity 83.91%, and the Jordan index was 0.681. Conclusion Serum CPT and various uterine artery blood flow parameters have certain clinical application value for the early screening of PE, and serum CPT combined with PI can significantly improve the predictive performance.

Objective To explore the value of BACs-on-Beads (BoBs) combined with karyotype analysis in prenatal diagnosis. Methods Amniotic fluid was collected from 2,500 single pregnancy pregnant women who received invasive prenatal diagnosis in our hospital from June, 2016 to January, 2019. At the same time, the BoBs detection and G-banding karyotype analysis of amniotic fluid cells were carried out among these subjects. Results 93 cases of fetal chromosomal abnormalities were detected by BoBs technique, with the detection rate 3.72%. Among them, 78 cases of chromosomal number abnormality (4 cases of trisomy 13, 19 cases of trisomy 18, 34 cases of trisomy 21, 9 cases of XXX, 6 cases of XXY and 6 cases of XYY), 6 cases of chromosomal structure abnormality (not detected by the karyotype analysis) and 6 cases of chimeric chromosome were found. Of the 6 fetuses with abnormal chromosome structure, 1 was DiGeorge syndrome and 1 was Williams Beuren syndrome, while the other 4 were chromosome microdeletion / microduplication syndrome. The detection rate of karyotype analysis was 4.56% (114 / 2500), and the detection rate of chromosome number abnormality was the same as that of BoBs. In addition, 21 chromosome structural abnormalities and 6 chimeric chromosomes were detected by the karyotype analysis. Conclusion Chromosomal karyotype analysis combined with BoBs technology has technical advantages based on knowledge of cytogenetics and molecular genetics, which can greatly improve the detection rate of chromosomal abnormalities, and is worthy of clinical application and promotion.

Objective To investigate the expressions of serum fetuin A and fetuin B in gestational diabetes mellitus (GDM) and their relationships with pregnancy outcome. Methods From October, 2018 to June, 2019, 82 patients with GDM who were treated in our hospital were selected as the GDM group. According to the pregnancy outcome of the patients, they were divided into adverse pregnancy group and normal pregnancy group. Another 50 healthy pregnant women who underwent birth examination in our hospital during the same period were selected as the control group. The general data of all subjects were collected and the levels of serum fetuin A and fetuin B were measured. In addition, systolic blood pressure, diastolic blood pressure, total cholesterol, triacylglycerol, fasting blood glucose (FBG), HbA1c and other indexes were collected. The risk factors of adverse pregnancy outcome in patients with GDM were analyzed. The predictive value of serum fetuin A and fetuin B for adverse pregnancy outcome in patients with GDM was analyzed by receiver operating characteristic curve (ROC). Results The pre-pregnancy body mass index, fetuin A and fetuin B of the GDM group were significantly higher than those of the control group (P<0.05). The age, FBG, HbA1c, fetuin A and fetuin B of the adverse pregnancy group were significantly higher than those of the normal pregnancy group (P<0.05). ROC curve analysis showed that serum fetuin A and fetuin B had a certain predictive value for the adverse pregnancy outcome of patients with GDM. The area under the curve of fetuin A was 0.758, while the area under the curve of fetuin B was 0.676, and the combined detection of the two could further improve the predictive value. Logistic regression analysis showed that age, FBG, HbA1c, fetuin A and fetuin B were all risk factors of adverse pregnancy outcome in patients with GDM (P<0.05). Conclusion Serum fetuin A and fetuin B have abnormally high expressions in GDM, and both of them are risk factors of adverse pregnancy outcome in patients with GDM. Combined detection of these two markers has a certain predictive value for pregnancy outcome of patients with GDM.

Objective To investigate the correlations between levels of serum cystatin C (CysC), N-terminal pro-brain natriuretic peptide (NT-proBNP), uric acid (UA) and C-reactive protein (CRP) and disease severity and cardiac involvement in patients with chronic obstructive pulmonary disease (COPD). Methods The levels of serum CysC, NT-proBNP, UA and CRP were measured among 112 COPD patients, and the re-examination was performed 3 months after the treatment. The percentage of FEV1 in the predicted value (FEV1% predicted value) was determined among COPD patients, and the correlations between CysC, NT-proBNP, UA and CRP and FEV1% predicted value were analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of CysC, NT-proBNP, UA and CRP on chronic cor pulmonale (CCP), and the area under the curve (AUC) was calculated. Results The serum levels of CysC, NT-proBNP, UA and CRP in patients with acute COPD were higher than those in patients with stable COPD (P<0.05). The serum CysC level in patients with grade IV was higher than that in patients with grades I, II or III (P<0.05). The comparison of serum NT-proBNP and UA showed a pattern as grade III> grade II>grade I (P<0.05), and comparison of serum CRP showed a pattern as grade IV> grade III>grade II>grade I (P<0.05). Serum levels of CysC, NT-proBNP, UA and CRP were significantly negatively correlated with FEV1% predicted value (P<0.05). The serum levels of CysC, NT-proBNP, UA and CRP in patients with CCP were higher than those in patients without CCP (P<0.05). The AUC values of serum CysC, NT-proBNP, UA and CRP in the diagnosis of CCP were 0.602, 0.932, 0.770 and 0.682, respectively. The levels of serum CysC, NT-proBNP, UA and CRP in patients with COPD were decreased significantly after 3 months of treatment (P<0.05). Conclusion The levels of serum CysC, NT-proBNP, UA and CRP in patients with COPD are significantly positively correlated with disease severity, and have a high diagnostic value on CCP, and they can provide an important serological basis for the assessment of COPD patients.

Objective To investigate the expressions of microRNA-7977 (miRNA-7977) and nuclear receptor 4A1 (NR4A1) in patients with lupus nephritis (LN), and to analyze their correlations with the disease severity. Methods 98 LN patients (the LN group), 50 patients with systemic lupus erythematosus (the SLE group) and 50 cases of healthy individuals (the control group) in our hospital from August, 2017 to August, 2019 were enrolled for the study. The expression levels of miR-7977 and NR4A1 in peripheral blood were compared among these groups, and compared among patients with different severity degrees. Spearman correlation analysis was used to determine the correlations between miR-7977, NR4A1 and development and severity of the disease. The predictive value of miR-7977 and NR4A1 for LN was analyzed by receiver operating characteristic curve (ROC). Results The expression levels of miR-7977 and NR4A1 in the peripheral blood of the SLE group were significantly lower than those of the control group (P<0.05). The expressions of miR-7977 and NR4A1 in peripheral blood of the LN group were significantly lower than that of the SLE group (P<0.05). The expressions of miR-7977 and NR4A1 in peripheral blood of patients with active LN were significantly lower than that of patients with stable LN (P<0.05). miR-7977 and NR4A1 were negatively correlated with the development and severity of LN (P<0.05). The predicted value of NR4A1 for LN was significantly better than that of miR-7977 (P<0.05). The predicted value of combined detection of miR-7977 and NR4A1 was significantly better than that of the single detection (P<0.05). Conclusion miR-7977 and NR4A1 are decreased in peripheral blood of LN patients, which are associated with the occurrence and severity of the disease. These markers can be used as molecular references for predicting the onset and progression of lupus nephritis.  

Objective To study the diagnostic value of serum CEA, Cyfra21-1, VEGF, STK1 and SF levels in patients with non-small cell lung cancer (NSCLC). Methods 85 NSCLC patients admitted to our hospital from July, 2018 to June, 2019 were selected as the study group, while 85 patients with pulmonary benign diseases as the control group and 85 healthy people as the health group. The CEA, Cyfra21-1, VEGF,STK1 and SF levels of the three groups were compared, and the relationships between these three groups with NSCLC disease were analyzed by logistic multiple factor regression analysis. Also, the combined detection of CEA, Cyfra21-1, VEGF, STK1 and SF levels to determine the diagnostic efficacy of NSCLC was evaluated. Results The levels of CEA, Cyfra21-1, VEGF, STK1 and SF in the study group and the control group were significantly higher than those in the healthy group (P < 0.05), and the levels of CEA, Cyfra21-1, VEGF, STK1 and SF in the study group were significantly higher than those in the control group (P < 0.05). Logistic regression analysis showed that serum CEA, Cyfra21-1, VEGF, STK1 and SF levels were independent risk factors of NSCLC. In addition to the sensitivity which was slightly lower than SF index detection, the sensitivity, specificity, Jordan index and area under ROC curve of the combined detection were all higher than those of three individual detections, suggesting a better diagnostic value. Conclusion Combining CEA, Cyfra21-1, VEGF, STK1 and SF levels to diagnose NSCLC disease has a high detection efficiency. This method is convenient, fast and can  find high-risk groups in real-time, which has a good clinical reference value.

Objective To analyze the value of combined detection of uIL-18, ET-1 and persepsin in the diagnosis of acute kidney injury in patients with renal calculi. Methods 100 patients with acute kidney injury (AKI) in our hospital from January, 2016 to January. 2019 were enrolled as the observation group, while 100 patients with non-AKI after renal calculus were selected as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of ET-1 and persepsin in the blood of patients and uIL-18 in urine. ROC curve was used to analyze the application of each index alone or in combination in the diagnosis of acute kidney injury after renal calculi. Results The levels of ET-1 and persepsin in the observation group were significantly higher than those in the control group. The level of uIL-18 in urine for the observation group was also significantly higher than that in the control group (P<0.05). The patient groups were identified using different clinical indexes as the gold standard. There were 98 cases of AKI using uIL-18 as the diagnostic index, while 90 cases of AKI using ET-1 as the diagnostic index, 99 cases of AKI using persepsin as the diagnostic index, and 96 cases of AKI when combined three indicators as the diagnostic index. The combination of uIL -18, ET-1 and persepsin was used to evaluate the sensitivity, specificity, positive predictive value, negative predictive value and AUC of AKI after renal calculus, which were all significantly higher than any of the single-index test (P<0.05). Conclusions The combined detection of uIL-18, ET-1 and persepsin can effectively improve the diagnostic performance of acute renal injury after renal calculi surgery.

Objective To explore expressions of serum β2 microglobulin (β2-MG), hepatocyte growth factor (HGF) and transforming growth factor-β1 (TGF-β1) in patients with acute myeloid leukemia (AML) and their clinical significances. Methods 96 AML patients who were diagnosed and treated in the hospital from January, 2010 to January, 2018 were enrolled as the disease group, while 35 healthy volunteers who underwent physical examination during the same period were enrolled as the healthy group. The levels of serum β2-MG, HGF and TGFβ1 were compared between the two groups. The expression levels of serum β2-MG, HGF and TGFβ1 among AML patients with different pathological features and curative effect were analyzed. And a correlation analysis was also performed. Results Compared with the healthy group, levels of serum β2-MG and HGF were significantly increased in the disease group, while level of TGFβ1 was significantly decreased (P<0.05). The levels of serum β2-MG and HGF in AML patients with recurrence and abnormal karyotype were significantly higher than those without recurrence and with normal karyotype, while level of TGFβ1 was significantly lower than that without recurrence and with normal karyotype (P<0.05). The levels of serum β2-MG and HGF in AML patients with complete remission were significantly lower than those without remission, while level of TGFβ1 was significantly higher than those without remission (P<0.05). Pearson correlation analysis indicated that curative effect of AML patients was significantly negatively correlated with serum β2-MG and HGF (r=–0.456, –0.462), while significantly positively correlated with TGFβ1 level (r=0.498). The recurrence rate was significantly positively correlated with serum β2-MG and HGF, (r=0.468, 0.511), while significantly negatively correlated with TGFβ1 (r=–0.568) (P<0.05). Conclusion Relative to healthy subjects, the serum β2-MG and HGF of AML patients are highly expressed, while TGFβ1 is lowly expressed. These three markers are closely related to curative effect of chemotherapy and prognosis in AML patients, which could be applied as effective markers for the early diagnosis and treatment of AML.

Objective To evaluate the anesthetic effect of Compound Articaine hydrochloride injection in the preparation of vital pulp teeth in middle and old-aged population. Methods According to the inclusion criteria and exclusion criteria of clinical trials, 141 patients with vital pulp teeth were selected for crown and bridge restoration. 153 vital pulp abutments were randomly divided into three groups. The observation group consisted of 49 domestic compound articaine hydrochloride injection, while the control group 1 consisted of 51 French articaine hydrochloride and epinephrine tartrate injection and the control group 2 consisted of 53 lidocaine hydrochloride. According to the patient's expression and doctor's evaluation, the analgesic effect, the onset time and maintenance duration of anesthesia and the incidence of adverse reactions were observed and analyzed. Results The effective rate (significant + effective) was 95.91% in the observation group, with 2.84 minutes for the onset time, 2.8±0.5h for the maintenance duration, while 96.08% in the control group 1, with 2.80 minutes for the onset time, 2.8±0.6h for the maintenance duration, and 79.25% in the control group 2, with 3.38 minutes for the onset time and 1.5±0.4h for the maintenance duration. There was no significant difference in analgesic effect, onset time and maintenance duration between the observation group and the control group 1. There were significant differences in analgesic effect, onset time and maintenance duration between the observation group and control group 2, also between control group 1 and control group 2. There were no adverse reactions such as local pain, edema, dizziness, nausea, vomiting and allergy caused by drugs in all three groups. Conclusion The anesthesia effect of domestic compound articaine hydrochloride injection is similar to that of French articaine hydrochloride and epinephrine tartrate injection. In the preparation of all ceramic crowns for middle and old-aged population, it is a safe and reliable local anesthetic with quick effect, strong anesthesia and little side effect, which is worth popularizing.

Objective To analyze the effects on the expression and diagnostic efficacy of serum cholinesterase (CHE), albumin (ALB) and cholesterol (CHO) in patients with hepatitis cirrhosis. Methods A total of 118 patients with hepatitis cirrhosis who were treated in our hospital from January, 2018 to February, 2019 were enrolled as the cirrhosis group, while 61 patients with hepatitis B as the hepatitis group and another 115 healthy subjects underwent physical examination as the control group. The cirrhosis group and hepatitis group were further divided into A, B and C level groups according to Child-Pugh criteria. The liver function indexes, including CHE, ALB, and CHO levels, and clinical diagnostic efficacy were compared among those groups, and A, B, C level sub-groups. Results The levels of serum CHE, CHO and ALB in the cirrhosis group and hepatitis group were significantly lower than those in the control group (P<0.05). The levels of CHE, CHO and ALB decreased with ABC levels in the cirrhosis group (P<0.05). There was no significant difference in the positive rates of CHE, CHO and ALB among the groups of A, B and C (P>0.05). By comparing the positive rates of CHE, CHO and ALB in each group, the positive rate of CHE was higher than that of CHO and ALB (P<0.05). The correlation coefficients of CHE and CHO, CHE and ALB, CHO and ALB were 0.846, 0.768 and 0.884, respectively (all P<0.05). The clinical efficacy showed that the sensitivity of CHE/CHO/ALB was the highest with 100%, the specificity of CHE was highest with 95.2%, and the area under the ROC curve (AUC) for CHE/CHO/ALB was 0.947. Conclusions The levels of CHE, CHO and ALB are significantly lower in patients with hepatitis cirrhosis and have a observable correlation with Child-Pugh classification, in which CHE has the highest sensitivity, while the combined detection has the best diagnostic performance in patients with hepatitis cirrhosis.

Objective To examine the expression of miR-4746 in Oesophageal Squamous Cell Carcinoma and to study the effect of miR-4746 on the proliferation of ESCC cells. Methods Samples of cancer tissues and tissues adjacent to cancer of ESCC patients were collected. RT-PCR and western blot were performed to determine the mRNA and protein levels of miR-4746 and PRKACB, then the correlation between the mRNA level of miR-4746 and PRKACB were analyzed. EC9706, HET-1A and TE-1 cell lines were cultured and transfected with miR-control, miR-4746 mimic or miR-4746 inhibitor, respectively, then the mRNA expression of PRKACB were determined by RT-PCR and the proliferation of these cell lines were determined by MTT assay. Results The expressions of miR-4746 and PRKACB were significantly down-regulated in cancer tissues of ESCC, and there was a positive correlation between the expression level of miR-4746 and PRKACB. The expression of PRKACB and the proliferations of EC9706, HET-1A and TE-1 cell lines were promoted after transfected with miR-4746 mimic, while the expression of PRKACB and the proliferations of EC9706, HET-1A and TE-1 cell lines were suppressed after transfected with miR-4746 inhibitor. Conclusion miR-4746 up-regulates the expression of PRKACB and promotes the proliferation of Oesophageal Squamous Cell Carcinoma Cells

Objective To investigate and analyze the effects of dexamethasone combined with recombinant BPI protein on pulmonary function, ultrastructure of AEC-II cells and expression of soluble B7-H3 (sB7-H3) and soluble programmed death molecule-1 (sPD-1) in mice infected with Mycoplasma pneumoniae. Methods 120 healthy mice (clean grade, weight 20 g - 25 g) were divided into the control group and the observation group according to random number table method, with 60 mice in each group. All mice were successfully infected with Mycoplasma pneumoniae (by infection with Mycoplasma pneumoniae). The mice in the control group were randomly divided into the untreated group, one-week group (treated with dexamethasone) and two-weeks group (treated with dexamethasone), with 20 mice in each group. The mice in the observation group were randomly divided into the untreated group, one-week after treatment group (dexamethasone + recombinant BPI protein), and two-weeks after treatment group (dexamethasone + recombinant BPI protein), with 20 mice in each group. The lung function, ultrastructure of AEC-II cells, relative expression of sB7-H3 and sPD-1 were observed before treatment, 1 week and 2 weeks after treatment. Results There was significant difference in lung function between the two groups before and after treatment (P < 0.05). After treatment, the lung function of the two groups increased significantly, but the lung function of the observation group was significantly higher than that of the control group (P < 0.05) after treatment for one week and two weeks; also there was no significant difference in the ultrastructure of AEC-II between the two groups before treatment, and the ultrastructure of aec-ii in the observation group was significantly better than that of the control group. After treatment, the levels of sb7-h3 and sPD-1 in the two groups were significantly lower than those in the control group (P <0.05). Conclusion Recombinant BPI protein combined with dexamethasone can effectively reduce the expressions of sB7-H3 and sPD-1 in mice infected with Mycoplasma pneumoniae, further improve the lung function, and reduce the ultrastructural damage of AEC-II cells.

Objective To explore the clinical significance of fluorescence quantitative polymerase chain reaction (FQ-PCR) in the detection of serum HBV DNA among patients with chronic hepatitis B. Methods The clinical data of 248 patients with chronic hepatitis B were analyzed retrospectively. Serum HBV DNA and HBV-M were detected by FQ-PCR and HBV DNA level was compared among different HBV-M patients. The serum HBV DNA levels of patients with different disease status were also compared. Furthermore, the T lymphocyte subsets and abnormal rates in peripheral blood of patients with different HBV DNA expressions were compared. Lastly, the relationship between the level of serum HBV DNA and the level of peripheral blood T lymphocyte subsets was analyzed. Results Comparison of serum HBV DNA levels in different HBV-M patients showed results as: HBsAg + HBeAg + HBcAb > HBsAg + HBeAg > HBsAg + HBsAb + HBcAb > HBsAg + HBeAb > HBsAb + HBeAb + HBeAb + HBcAb > HBcAb / HBsAb + HBeAb / HBeAb + HBeAb. Among these comparisons, there were pairwise significant differences in serum HBV DNA levels (P<0.05), except for HBcAb, HBsAb + HBeAb and HBeAb + HBcAb (P > 0.05). Comparison of serum HBV DNA levels in patients with different disease status showed results as: severe patients > moderate patients > mild patients (P < 0.05). Comparison of CD3+, CD4+, CD4+/CD8+ in different HBV DNA expression patients showed results as: HBV DNA negative patients > low copy patients > high copy patients (P < 0.05). Comparison of abnormal rates of CD3+, CD4+, CD4+/CD8+ in different HBV DNA expression patients showed results as: HBV DNA negative patients > low copy patients > high copy patients (P < 0.01). The serum HBV DNA level was negatively correlated with CD3+, CD4+, and CD4+/CD8+ (r =–0.789, –0.812, –0.706, P = 0.012, 0.007, 0.001). Conclusion The detection of serum HBV DNA level by FQ-PCR is closely related to the level of HBV-M, disease condition and T lymphocyte subsets in peripheral blood.

Objective To examine the impact of sample (serum and heparin lithium plasma) storage condition on the test results of CKMB mass. Methods Fresh samples (serum and heparin lithium plasma) were collected from a hospital, and samples were separated and stored in different conditions according to a pre-designed plan. The relationship between the measured value of CKMB mass and the preservation temperature and freeze-thaw process was investigated. Results There were some fluctuations in the stability of low-level（5ng/mL） serum samples. Serum samples and heparin lithium plasma samples stored at –80 ℃ were better than other storage conditions. Also, a decreasing trend of results was observed after freeze-thaw of samples (serum and heparin lithium plasma). Conclusion  The samples (serum and heparin lithium plasma) should be tested at the same day of the collection. For samples to be retested, they should be stored at –80℃. Repeated freeze-thaw is not recommended because it can cause the deviation of the measured value.

Objective To evaluate the analytical performance of CK-MB mass detected by an automatic biochemical analyzer quantitative detection system, so to confirm the accuracy of the results. Methods  Referring to the CLSI series document: "National relevant health industry standards" and also by considering our actual working environment, five aspects (including the precision, accuracy, linear range, clinical reportable range and biological reference interval, et al.) of CK-MB mass were evaluated. Results were then compared with the allowable range of quality, and to verify the inversion of CK-MB/CK. Results CK-MB mass was measured by Beckman AU5400 automatic biochemical analyzer. When CK-MB levels were at 14.185 and 36.467ng/mL, the Intra-batch unrefined density（CVr）were 2.778%, 2.172%, and the total unrefined density（CVl）were 4.507%, 2.255%, respectively. When compared with patient samples with CK-MB mass measured by Roche E602 automatic electrochemiluminescence analyzer, the review equation was: Y = 1.0277 X – 0.5778, with R2=0.9846, and showed a good correlation. The expected bias at the concentration levels of 5,10,15,90 ng/mL was –8.8%,–3.0%,–1.1%, and 2.1% respectively, which was acceptable. The linear range was 1.865-186.34ng/mL. The clinical reportable range was 1.865-1490.72ng/mL. The biological reference interval was 0 to 5ng/mL, which was suitable for our laboratory. It was able to correct the inversion of CK-MB/CK in our laboratory very well. Conclusions Determination of CK-MB mass by Beckman AU5400 automatic biochemical analyzer is evaluated in the current study. The main performances of the detection system are accorded with the requirements, which is able to standardize detection, ensure the quality of testing, and meet the clinical need．

Objective To evaluate the performance and clinical application of an immunoturbidimetric serum albumin test kit. Methods According to the standard requirements of CLSI, the precision, accuracy, detection limit, linear range, interference experiment, reference range and methodology comparison of the kit were evaluated by using the automatic Hitachi biochemical analyzer 7600-020, and the test results were compared with the performance indexes provided by the manufacturer. Results The intra assay precision and inter assay precision of the reagent were 1.1% and 1.2%, respectively, which were less than the indexes provided by the manufacturer. The evaluation results of other parameters were as following: the accuracy was within the allowable bias range; the detection limit was 0.152g/L; the linear slope was 1.0195; the square R2 of the correlation coefficient was 0.9945, which was greater than 0.99 and met the requirements; the coincidence rate of the biological reference range was 100%. Within the range of the concentration of the interferents indicated in the manufacturer's instructions, there was no obvious influence on the test results. Compared with bromocresol green method, the correlation regression equation was Y = 0.9894X–1.1033, with R2 0.9794. The difference between the two methods was non-linear and could not be adjusted by the correction coefficient. Conclusion The main analytical performances of the immunoturbidimetric serum albumin test kit on 7600-020 biochemical analyzer meet the statement of the manufacturer, in which the results are accurate and reliable, with a strong anti-interference ability. The tested kit can be applied for the clinical analysis.

Klebsiella pneumoniae is a common pathogen of nosocomial infections in the clinic, often causing infections in urinary system, respiratory system and bloodstream. In recent years, chronic infections caused by Klebsiella pneumoniae biofilms have received increasing attentions, and a large number of research has been conducted on Klebsiella pneumoniae biofilms. In order to adapt to the surrounding unfavorable environment, Klebsiella pneumoniae will form a biofilm, which is a type of living relative to planktonic bacteria. The biofilm consists of bacteria and its own secreted metabolites (extracellular polysaccharides, proteins, extracellular DNA, lipids, etc.) . Klebsiella pneumoniae in the biofilm state is extremely resistant, and it is easy to escape from the immune attack of the body, which makes it difficult to be removed completely, making the clinical anti-infection more challenging. This article briefly reviews the biofilm formation process of Klebsiella pneumonia,, the mechanism of drug resistance of bacteria in biofilm state, determination methods and prevention approaches of biofilm.

It is believed that the main reason of the appearance of fetal red blood cells in maternal peripheral blood circulation is the pressure difference between umbilical artery and villus space. If the chorionic barrier is damaged, the blood of the fetus will pass through the chorionic space, enter the maternal body, and finally appear in the maternal peripheral blood circulation. In general, a small amount of fetal red blood cells may appear in the maternal peripheral blood circulation, which is a normal condition, and there is no obvious adverse reaction between the fetus and the maternal body. However, when the blood volume of the fetus entering the maternal body exceeds a certain threshold, it will lead to the transfusion syndrome of the mother and cause a serious clinical syndrome. This article mainly analyzes and summarizes the source of fetal red blood cells, the existing detection methods, the diagnosis and treatment of fetal mother blood transfusion syndrome, also the correlation with neonatal anemia, the value in prenatal diagnosis, and the prediction of pre-eclampsia, so to provide the knowledge basis for the clinical diagnosis and treatment.