PurposeThis study aims to investigate the impact of Fusobacterium nucleatum (F. nucleatum) infection on distant metastasis in breast cancer and its underlying mechanisms.MaterialsClinical breast cancer samples were collected, and F. nucleatum was identified through bacterial isolation and culture. In vitro and in vivo infection models were established using the isolated bacteria. The impact of F. nucleatum infection on breast cancer cell proliferation and migration was evaluated. High-throughput sequencing and bioinformatics analyses were performed to identify microRNAs exhibiting significant expression changes following F. nucleatum infection. Gene knockdown of miR-21-3p was utilized to assess its role in F. nucleatum-mediated epithelial-mesenchymal transition and cell migration. Online databases predicted the downstream targets of miR-21-3p, which were subsequently validated in cell models. Additionally, the effect of silencing FOXO3 on F. nucleatum-induced cell migration was examined.ResultsBoth in vitro and in vivo experiments showed that F. nucleatum infection did not affect cell proliferation but significantly enhanced EMT and migration. miR-21-3p was significantly upregulated after infection, and silencing it reduced F. nucleatum-induced migration. FOXO3 was identified as a downstream target of miR-21-3p, and silencing FOXO3 further enhanced cell migration.ConclusionF. nucleatum promotes breast cancer cell migration through the miR-21-3p/FOXO3 pathway. This study highlights the role of F. nucleatum in breast cancer metastasis and suggests potential therapeutic targets for intervention.

目的 建立鉴别和筛查广州和佛山地区珠蛋白生成障碍性贫血患者的红细胞参数方程,评估其鉴别和筛查效能.方法 收集2017-2021年在广东广州和佛山三家医院就诊的珠蛋白生成障碍性贫血患者3026例作为珠蛋白生成障碍性贫血组,缺铁性贫血(IDA)患者1044例作为IDA组,门诊普通患者和体检者14638例作为对照组.检测所有受试者的红细胞计数(RBC)、红细胞分布宽度(RDW)、血红蛋白(Hb)、血细胞比容(HCT)、红细胞平均体积(MCV)、红细胞平均血红蛋白(MCH)、红细胞平均血红蛋白浓度(MCHC).采用多因素Logistic回归分析建立珠蛋白生成障碍性贫血-IDA的鉴别方程(简称GF),计算GF用于鉴别珠蛋白生成障碍性贫血和IDA的准确度、灵敏度和特异度;采用整体鉴别指数(IDI)和净重新分类指数(NRI)指标评价其鉴别效能.采用多因素Logistic回归分析建立珠蛋白生成障碍性贫血-IDA的筛查方程(简称STF),计算STF作为珠蛋白生成障碍性贫血筛查指标时的各种性能指标.结果 拟合的鉴别方程为GF=0.291×MCH-0.135×MCV+0.985×RBC+0.13×RDW+0.491×MCHC.该方程鉴别珠蛋白生成障碍性贫血的最佳临界值为18.73,约登指数为0.597,曲线下面积(AUC)为0.874,与其他文献方程之间的差异有统计学意义(P<0.05),GF的IDI和NRI值均大于其他方程.拟合的筛选方程为STF=5.034×RBC+0.21×Hb+0.187×MCV+0.088×RDW-0.144×MCH-0.062×MCHC-60.2337×HCT,该方程筛查珠蛋白生成障碍性贫血的AUC为0.876,阴性预测值为96.64％.结论 在广州和佛山地区,相比于其他文献的鉴别方程,GF鉴别珠蛋白生成障碍性贫血和IDA的效果更好.STF用于筛查珠蛋白生成障碍性贫血时,漏诊率较低,可作为广州和佛山地区珠蛋白生成障碍性贫血初筛指标.

目的:对一款新近研发的循环增强荧光分析仪及配套降钙素原(PCT)试剂盒进行系统性的性能评价,并对新版美国临床实验室标准协会(CLSI)文件的适用性进行验证.方法:依据目前最新版CLSI文件(EP5-A3、C28-A3和EP9-A3),对国产的循环增强荧光分析仪及配套PCT定量检测试剂盒与进口Roche公司COBAS e411电化学发光免疫分析仪及其配套PCT试剂分别检测人血标本中的PCT含量进行对比评价,验证循环增强荧光分析仪及配套PCT试剂盒的低值血清质控品批内变异系数(CV)、检测偏差、整体符合率以及批间偏差等分析性能.结果:循环增强荧光分析仪低值血清质控品批内CV为6.5％,实验室内总CV为8.7％,高值血清质控品批内CV为5.3％,实验室内总CV为8.0％;血清临床可报告范围为0.032～827 ng/ml;健康人群血清PCT第95百分位为0.047 ng/ml,全血PCT第95百分位为0.066 ng/ml;血红蛋白(500 mg/dl)、胆红素(10 mg/ml)和甘油三酯(500 mg/dl)对血清检测结果的偏差均<15％;检测全血、血浆及血清PCT与Roche检测血浆PCT整体符合率分别为91.1％、95.5％及93.3％;3个批号的循环增强荧光分析仪试剂批间偏差均<15％.结论:循环增强荧光分析仪检测系统的各项分析性能良好,可用于医学实验室进行常规PCT标本检测.

Background: In order to ensure the accuracy of the product, we established 1st model of metrological traceability hierarchy for light-initiated chemiluminescent assay (LICA) of 17 beta-estradiol (E-2) at the manufacturer, based on International Organization for Standardization (ISO) 17511:2020. Moreover, we verified/validated the basic performance (such as matrix effect and long-term stability of end-user IVD MD calibrator, precision, linearity interval, accuracy/ trueness, and detection capability) at the clinical end-user. Methods: Human serum samples were used in this study. E-2 was detected by mass spectrometry (MS) and LICA. The metrological traceability of LICA for E-2 was established according to ISO 17511: 2020 standards, and pools of human samples were used as the m.3. secondary calibrator. Precision was validated according to Clinical and Laboratory Standards Institute (CLSI) EP05-A3. The linear interval was verified according to CLSI EP06-ED2. Comparison of accuracy and trueness of E-2 with MS and Roche according to CLSI EP09-A3. The detection capability was validated according to EP17-A2. Matrix effect and long-term stability evaluation of end-user IVD MD calibrator were carried out according to CLSI EP14-A2, EP25-A. Statistical software was used for data analyses. Results: The use of pools of human samples and fine adjusting calibrators ensured the accuracy of end-user test results. The metrological traceability of LICA for E-2 was established. It showed excellent precision, meeting the requirements of allowable imprecision (7.5%). The allowable deviation from linearity (ADL) of 5% was allowed to show a good linear interval (12.52-4167.25 pg/ml). The accuracy/ trueness was verified, and relative deviation in the medical decision level met the performance specification of 10.03% compared with MS or Roche. The validated limit of blank, limit of detection, and limit of quantitation of E-2 were 4.95 pg/ml, 8.93 pg/ml, and 9.88 pg/ml, respectively (the allowed imprecision is 20.00%). The interference rate of E2 ranged from -5.5% to 6.6%. Conclusion: LICA showed high sensitivity, high specificity, excellent precision, wide linearity interval, IVD MD calibrator has long-term stability, and no matrix effect. The metrological traceability of E-2 established by using pools of human samples as M.3. can deliver accuracy to the end-user IVD MD and show good consistency with MS and Roche.

Background To investigate the differences between doublet and triplet neoadjuvant chemotherapy (NAC) regimens in efficacy and safety profile. Methods A total of 227 locally advanced gastric cancer (LAGC) patients who received NAC and sequential radical gastrectomy were reviewed. After propensity score matching (PSM), 140 patients with similar baseline characteristics were selected. Among them, 70 received doublet NAC regimens consisted of platinum and fluorouracil; the other 70 received triplet NAC regimens consisted of docetaxel, platinum, and fluorouracil. Results The efficacy of doublet and triplet regimens was comparable after propensity score matching in terms of tumor regression (pathological complete response, Doublet 11.4% vs. Triplet 15.7%, p = 0.642), achieving of R0 resection (Doublet 88.6% vs. Triplet 88.6%, p = 1), 1-year disease-free survival (DFS) (Doublet 77.1% vs. Triplet 68.6%, p = 0.178), 3-years overall survival (OS) (Doublet 54.3% vs. Triplet 60.9%, p = 0.941). Post-surgery complications were more common in the triplet cohort (Doublet 5.7% vs. Triplet 27.1%, p = 0.001), especially abdominal infection (Doublet 0% vs. Triplet 11.1%, p = 0.001). Conclusions A more intense preoperative triplet NAC regimen does not bring extra downstage effect and survival benefit compared to a doublet regimen. It may even result in a higher risk of post-surgery complications.

目的 探讨血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞百分比(NEUT％)检测在细菌性与病毒性肺炎诊断中的价值.方法 将该院176例肺炎确诊患者纳入研究,其中细菌性肺炎患者67例(细菌组),病毒性肺炎患者109例(病毒组);另外,选取90例健康体检者作为对照组.检测上述人群SAA、CRP、WBC、NEUT％水平;对各组检测数据进行分析.结果 细菌组与对照组SAA、CRP、SAA/CRP、WBC及NEUT％水平比较差异均有统计学意义(P<0.05);病毒组与对照组SAA、CRP、SAA/CRP水平比较差异均有统计学意义(P<0.05);细菌组和病毒组WBC、SAA、CRP、SAA/CRP比较差异有统计学意义(P<0.05).5项指标单独用于细菌性肺炎诊断的受试者工作特征(ROC)曲线显示,曲线下面积(AUC)由大到小依次为SAA、CRP、WBC、NEUT％、SAA/CRP;进一步采用logistic回归分析:SAA、CRP的偏回归系数最大,表明SAA、CRP对细菌性肺炎的诊断效能较大;5项指标联合检测的AUC为0.999.各项指标单独用于病毒性肺炎诊断的ROC曲线显示,AUC由大到小依次为SAA、SAA/CRP、CRP、NEUT％、WBC;进一步采用logistic回归分析:SAA的偏回归系数最大,表明SAA对病毒性肺炎感染的诊断效能最大,5项指标联合检测的AUC为0.983.SAA/CRP比值用于鉴别细菌性与病毒性肺炎的ROC AUC为0.821,诊断阈值为6.8.结论 SAA、CRP可作为细菌性肺炎诊断的良好指标,SAA可作为病毒性肺炎诊断的良好指标;SAA/CRP比值可用于鉴别细菌性和病毒性肺炎.

目的 探讨罗氏Modular P800全自动生化分析仪使用低密度脂蛋白胆固醇(LDL-C)试剂对载脂蛋白A1(ApoA1)检测比色杯携带污染的干扰效应.方法 使用罗氏公司和积水公司的LDL-C试剂盒在罗氏Modular P800全自动生化分析仪上分别检测不同浓度的LDL-C试剂对罗氏ApoA1检测的影响,并进行分析.结果 罗氏LDL-C试剂在Modular P800上对罗氏ApoA1的检测有明显干扰,且干扰程度随着LDL-C浓度的增加而增大;积水LDL-C试剂在Modular P800上对罗氏ApoA1的检测无干扰;酸性洗液和去离子水清洗均能够消除罗氏LDL-C试剂对罗氏ApoA1检测比色杯携带污染的干扰.结论 全自动生化分析仪存在比色杯的携带污染,影响结果的准确性,实验室可通过特殊清洗程序排除携带污染的影响,且应主动发现并排除携带污染,保证检测结果的准确性.

目的 探讨医院相关性(HCA)和社区获得性(CA)金黄色葡萄球菌菌血症(SAB)的流行病学特征和易感因素,评估菌血症治疗结果的死亡差异.方法 回顾性调查广州中医药大学第二附属医院2015年1月至2017年12月的SAB病例.以非SAB患者为对照组,对HCA-SAB和CA-SAB进行病例对照研究;比较甲氧西林敏感金黄色葡萄球菌(MSSA)和耐甲氧西林金黄色葡萄球菌(MRSA)菌血症的临床表现、相关因素和结局,通过多元Logistic回归分析SAB的死亡相关因素.结果 共收集264例SAB病例.与对照组比较,CA-SAB的相关因素为住院时间长(P＜0.001);HCA-SAB的相关因素为住院时间较长、3个月前有住院史、细菌感染史、入住护老院史、慢性肾衰、糖尿病病史以及入住重症监护病房(P均＜0.05).导致MRSA菌血症的独立相关因素为住院时长、糖尿病、抗生素用药史、社区获得性感染、不足够抗生素治疗.SAB 30 d死亡的相关因素为住院时长以及3个月前住院史.结论 治疗住院患者的过程中,应更加重视有住院史、社区获得性感染、抗生素使用史以及糖尿病史的患者,预防其感染SAB,尽量缩短住院天数,降低因感染SAB而致死的风险.

Objective:To explore the generating effect of epigallocatechin-3-gallate (EGCG) on amyloid-β peptide (Aβ) of model mice with Alzheimer's disease (AD) induced by D-galactose. Methods:Divided 60 cases of mice from Kunming randomly into the control group,the model group,the VE positive group,the EGCG groups of low,middle and high dose,10 cases in each group. After establishing the model mice with AD by injection of D-galactose,the control group and the model group were given equivalent double distilled water by gavage. The VE positive group was given 5.6％ VE by gavage once a day. The EGCG groups of low,middle and high dose were respectively given 2mg/kg 0.04％ EGCG,4mg/kg 0.08％ EGCG,6mg/kg 0.12％ EGCG by gavage once a day. After continuously treating for 28 days, observed the changes of animal behaviors by the step-through test and Morris water maze test, detected levels of interleukins-2(IL-2),interleukins-6 (IL-6),tumor necrosis factor-α(TNF-α) and Aβ in brain homogenate of mice by ELISA method, and observed the changes of neurons in hippocampus of mice by hematoxylin-eosin staining. Results:EGCG can obviously prolong the step-down latency,reduce the error frequency of step-down,shorten the passing time through maze and reduce the error frequency of entering dead end of the model mice with AD,and it can obviously relieve the injury of neurons in hippocampus of model mice with AD induced by D-galactose and reduce the expression levels of IL-6, TNF-α and Aβ, differences being significant(P ＜ 0.05). Conclusion:EGCG possibly can inhibit the apoptosis of neurons by reducing the content of Aβ of bain in the model mice with AD induced by D-galactose,so as to improve the learning and memory impairment.

目的 探讨猫爪草多糖(PRT)对半贴壁巨噬细胞株ANA-1细胞免疫功能的影响.方法 采用水提醇沉法提取和分离PRT;红外光谱法测定PRT分子结构;MTT法检测ANA-1细胞增殖能力;不同浓度的猫爪草多糖作用于脂多糖(LPS)诱导的ANA-1细胞,采用Griess法检测一氧化氮(NO)生成量;一氧化氮合酶(iNOS)测定试剂盒检测活性;RT-PCR法检测iNOS、白介素-6(IL-6)和肿瘤坏死因子α(TNF-α)mRNA水平的表达.结果 得到灰白色粉末状猫爪草多糖,多糖含量98.17％:红外光谱显示PRT的糖苷键为α-构型,具有吡喃型糖环;PRT增强ANA-1细胞增殖能力,上调IL-6和TNF-α mRNA的表达,且浓度为200μg/mL时作用最强;PRT呈浓度依赖性抑制LPS诱导的ANA-1细胞分泌NO和iNOS活性,当多糖浓度为100 μg/mL时,能够完全抑制iNOS mRNA的表达.结论 PRT能够增强ANA-1细胞增殖能力,上调IL-6和TNF-α mRNA水平的表达,抑制LPS诱导的ANA-1细胞分泌NO和iNOS的表达.

目的 强生干化学分析仪开放通道搭载国产普瑞柏血清淀粉样蛋白A(serum amyloid A,SAA)试剂盒的分析性能验证.方法 根据美国临床和实验室标准化协会(NCCLS)的检测仪器评价标准,并参照卫生部关于分析仪器的性能验证指南,对Vitros 5.1 FS检测SAA的精密度、准确度、线性范围、最大稀释度和生物参考区间进行验证.结果 2个水平SAA批内及总精密度分别为S批内低=0.3,S总低=0.45和S批内高=0.6,S总高=1.01,均小于厂家声明的精密度.比对实验决定系数r 2=0.9912,线性方程Y=0.9629X+0.2046,其线性范围可以验证至5.99～92.59 mg/L,最大稀释倍数可验证至10倍.23例健康个体中95.7％的个体SAA检测值处于厂家声明的参考区间之内.结论 Vitros 5.1 FS搭载该SAA试剂盒的分析性能验证通过,该检测系统可以用于临床常规标本检测.

Objective To evaluate the consistence between the Lucica-L and MAKER assay kits in analyzing glycated albumin. Methods 18~60 years old residents with the amount of 3004 was collected using the Nested sampling method in Guangzhou. The ALB and GA of the volunteers were assayed using Lucica-L kits and MAKER GA kits at the same time. The results were applied comparati ve t-test to perform statistical analysis. Results The difference of the concentrations of ALB and GA were Significant between the two analyzing kits(P<0.05). The final results of the two kits showed excellent correlation(r2=0.962), but the difference was still statistical significance(P<0.05). The bias was 2.6%. Conclusion The GA results assaying by MAKER kit were higher than Lucica-L assay kit. But the bias has clinical acceptability.

目的 评价HbA2和HbF检测在儿童β-地中海贫血(β-地贫)筛查中的应用价值.方法 选取β-地中海贫血患儿98例以及健康儿童105例作为研究对象,分别检测血浆中HbA2、HbF含量.结果 β-地贫组HbA2、HbF水平明显高于对照组(P＜0.01).HbA2、HbF及联合诊断β-地贫受试者工作特征曲线下面积分别为0.921,0.900,0.951,cutoff值分别为3.3％,0.6％.Logistic回归分析表明,与HbF相比,HbA2诊断价值更大.结论 HbA2和HbF检测对β-地贫诊断具有较高的灵敏度和特异性,是大规模筛查β-地贫比较理想的方法;且HbA2的诊断价值优于HbF;HbA2和HbF联合检测可提高儿童β-地贫的诊断符合率.

Objective To evaluate the analytical performance of Sysmex CS-2000i automatic blood coagulation analyzer.Methods PT,APTT,and Fib were detected by Sysmex CS-2000i automatic blood coagulation analyzer.The corresponding within-run precision,inter-day precision,linearity,trueness,and accuracy were analyzed.The WS/T 406-2012 document-a health industry standard of the People's Republic of Chinawas used to evaluated the aforementioned analytical performances.Results For PT,APTT,and Fib,the withinrun precision and the inter-day precision were 1.44％-3.58％ and 2.28％-4.88％,respectively.Fib had a good linearity within 0.32-7.79 g/L.Both the trueness and the accuracy could meet the requirement of WS/T 406-2012 standard.Conclusions The analytical performance of Sysmex CS-2000i automatic blood coagulation analyzer is able to meet the clinical requirement.The WS/T 406-2012 standard has good operability and practicability,and it is suitable to be applied and popularized in routine laboratory.

OBJECTIVE:To evaluate the bias of three different methods in determination of glycated hemoglobin A1c (HbA1c).METHODS:According to Clinical and Laboratory Standards Institute (CLSI)EP9-A3 document, 40 serum specimens among linear range were tested by immunoturbidimetry assay (Roche Tina-quant), capillary electrophoresis (Sebia Minicap FP), high performance liquid chromatography system (HPLC, Trinity Biotech Premier Hb 9210™). RESULTS were analyzed by pairwise comparision. The difference plots and scatter plots were analyzed. The results of outliers were examined by extreme studentized deviate (ESD) method. The best regression model was chosen to fit the regression equation and the biases were calculated at the level of medical decision and judged the comparability according to the half of Tea acceptance standard.RESULTS:Scatter plots and ESD results showed good correlation among test results of 40 samples, no abnormal values were found. Based on proportional difference deviation plots, proportional difference rank order deviation plots, numerical deviation plots and ranked order difference plots, weighted least squares (WLS) (Roche(X) vs sebia(Y1)), ordinary linear regression (OLR) (Roche(X) vs Trinity (Y2)) and Deming (Sebia(Y1) vs Trinity(Y2)) were chosen to fit regression analysis model. The regression equations were Y1 =-0.420 3+ 1.052 7X, Y2 =-0.174 0+ 1.027 0X, Y2=0.423 1+ 0.959 0Y1, respectively. Assuming the HbA1c medical decision points of 10%, 16% to regression equation, the proportional biases were 1.06% and 2.61% at Roche(X) and sebia(Y1) system, 0.96% and 1.60% at Roche(X) and Trinity (Y2) system, 0.13% and -1.47% at Sebia(Y1) and Trinity(Y2) system respectively, which were all lower than the acceptable values.CONCLUSION:The measurement values of HbA1c by capillary electrophoresis (Sebia Minicap FP), HPLC (Trinity Biotech Premier Hb 9210™) and immunoturbidimetry assay (Roche Tina-quant), are comparable.

Objective To discuss the clinical significance of serum neutrophil gelatinase associated lipocalin(NGAL)detection in the diagnosis of contrast induced nephropathy .Methods A total of 299 inpatients with contrast medium in department of inten‐sive care unit(ICU) ,department of cardiovascular disease ,department of urology from Guangdong Province Hospital of Traditional Chinese Medicine were enrolled ,and the fasting blood glucose and lipids were detected .Sera were collected before examination of contrast medium and 1 ,2 and 6 d after examination of contrast medium respectively .Serum creatinine(SCr)and cystatin C(CysC) were detected ,the concentration of NGAL was determined .CIN was defined as of increased by 44 μmol/L or 25% from baseline in SCr within 24-48 h .The NGAL detection variation tendency was analyzed in different time point .Results In 299 cases ,CIN oc‐curred in 28 patients ,the incidence rate was 9 .36% .The diabetes patients in the incidence of CIN was 16 .21% (12/74) ,no inci‐dence of diabetic patients was 7 .11% (16/225) .When compared with that of before contrast ,CIN in serum of patients with Cr and CysC coronary angiography in 2 d significantly increased after contrast medium ,returned to the level before angiography on 6 d .But the serum NGAL in angiography 1 d after it was significantly increased (P<0 .05) ,statistically significant differences compared with pre contrast ,and was still at a high level on sixth day .Conclusion Prediction of CIN level of serum NGAL in contrast after 1 d could be a good predictor for CIN ,and the prediction time is earlier than the serum levels of Cr and CysC .The level of serum NGAL can be used for early diagnosis of CIN .

Objective In this study ,we constructed a series of recombinant plasmids carriers expressing shRNA targeting hTERT and Bi‐1 gene .These recombinant plasmids carriers were transfected into CNE‐2Z cell lines using Lip and continuously in‐duced the expression of shRNAs .Furthermore ,the shRNAs caused the degradation of mRNAs homologous in sequence with the target genes ,which lead to a sequence‐specific gene silencing .Methods The CNE‐2Z cells was divided into untreated group ,pEG‐FP‐N1 group and pEGFP‐N1/Lip group .Flow cytometry(FCM ) was applied to determine the transfection efficiency .The changes of hTERT and Bi‐1 gene expression were detected by Real‐time RT‐PCR and Western blotting .Results The best transfection effi‐ciency between plasmid and Lip was 2 .5 μg plasmid and 6 .25μL Lip .Conclusion We constructed several shRNA recombinant eu‐karyotic expression plasmids successfully .The recombinant plasmid can inhibit the expression of hTERT and Bi‐1 gene specifically and effectively .

Objective To explore the value of CA153 ,CA125 and earcinoembryonic antigen(CEA) detection in follow‐up of postoperative breast cancer .Methods A total of 98 patients suffering from breast cancer recurrence (re‐currence group)and 107 patients without recurrence(non recurrence group) as the subject in this research from Au‐gust 2013 to August 2014 .All of patients were detected CA153 ,CA125 and CEA ,and the data were statistical ana‐lyzed .Results The level of CA153 ,CA125 and CEA in the recurrence group was significant higher than the non re‐currence group ,the difference was statistical significant (P<0 .01) .The area under receiver operating characteris tic curve(AUC) of CA153 was bigger than CA125 and CEA ,when the cutoff score was 21 .79 ng/mL ,the Youden index was the biggest ,the sensitivity was 80 .8% and the specificity was 91 .6% .According to the logistic regression analy‐sis ,the prediction efficiency of CA153 was better than CA125 and CEA .Conclusion The level of CA153 ,CA125 and CEA could provide reference for the early diagnosis of breast cancer recurrence and the diagnostic value of CA 153 is better than CA125 and CEA .

Objective To explore the significance of combined detection of D-Dimer,cardic troponin I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-ProBNP)in acute coronary syndrome and the correlation between them.Methods 143 patients with acute coronary syndrome were selected as the observation group,and 40 CAG negative people as the control group.The difference between the two groups was compared and the correlation was analyzed.According to different diagnostics,patients in the observa-tion group were separated into 3 groups,unstable angina pectoris,non ST segment elevation myocardial infarction and ST segment elevation myocardial infarction.The correlation of D-Dimer,cTnI and NT-ProBNP with the severity of coronary artery disease was analyzed.Results The levels of D-Dimer,cTnI and NT-ProBNP in the observation group were higher than those in the control group,and the difference was statistically significant(P < 0.05 ).The severity of coronary artery disease had positive correlation with the test results (P <0.05).Conclusion The combined detection of D-Dimer,cTnI and NT-ProBNP could help to diagnose the acute coronary syndrome and the test result has a positive correlation with the severity of acute coronary syndrome.

目的:探讨人附睾上皮分泌蛋白4(HE4)与CA125联合检测在卵巢癌的鉴别诊断以及预后评估中的研究价值.方法:189例女性分为卵巢癌患者50例(卵巢癌组),盆腔良性疾病患者99例(良性疾病组),健康女性40例(健康组),计算卵巢恶性肿瘤风险模型值(ROMA),比较3组HE4、CA125水平,比较HE4、CA125、ROMA 3种指标的灵敏度、特异性及比较15例卵巢癌患者术前术后的HE4、CA125的水平.结果:卵巢癌病变组的HE4与CA125水平明显高于良性病变组和健康对照组(P＜0.05);良性疾病组与健康对照组之间CA125水平差异有统计学意义(P＜0.05),HE4水平差异无统计学意义(P＞0.05).卵巢癌组术前术后CA125与HE4水平差异有统计学意义(P＜0.05).HE4、CA125和ROMA诊断卵巢癌的特异性分别为86.90％、87.90％ 、90.90％;阳性似然比分别为8.10、4.54、10.33;诊断符合率分别为53.69％、83.89％、87.25％.结论:单项HE4对于卵巢癌的早期诊断以及与盆腔良性疾病的鉴别诊断优于CA125,且术后评估价值高于CA125,HE4与CA125联合检测ROMA值可提高对卵巢癌诊断符合率.