Objective:To investigate the prognostic value of serum epithelial cadherin（E-cad）and hypoxia-inducing factor（HIF-1α）levels in patients undergoing modified radical mastectomy.Methods:A total of 112 patients who received modified radical mastectomy from June 2018 to June 2019 were included in the study. All patients received 2-year follow-up and were divided into a recurrence group and a non-recurrence group according to the recurrence situation within 2 years. χ2 test and t test were used to compare the baseline data，preoperative serum E-Cad and HIF-1α levels of the two groups. The influence of preoperative serum E-Cad and HIF-1α on the prognosis of breast cancer was tested by COX regression analysis. Receiver operating characteristic curve（ROC）and decision curve were drawn to analyze the prognostic value of preoperative serum E-Cad and HIF-1α levels in modified radical mastectomy.Results:In 112 patients with breast cancer followed up for 2 years after modified radical surgery，23 cases recurred，the recurrence rate was 20.5%（23/112）. The TNM stage and the incidence of lymph node metastasis in recurrent group were higher than those in non-recurrent group，the tumor size and preoperative serum HIF-1α level were higher than those in non-recurrent group，and the preoperative serum E-Cad level was lower than those in non-recurrent group（P < 0.05）. COX regression analysis showed that high TNM stage，lymph node metastasis，large tumor and preoperative high HIF-1α level were risk factors for postoperative recurrence of breast cancer patients（HR=3.696，4.061，7.739，1.052，P < 0.05），and preoperative high E-Cad level was protective factor（HR=0.313，P < 0.05）；ROC curve was drawn，and the results showed that the AUC of preoperative serum E-Cad and HIF-1α were 0.835 and 0.781，respectively，for predicting the prognosis of breast cancer patients after modified radical surgery. The decision curve was drawn，and the results showed that the combined prediction of preoperative serum E-Cad and HIF-1α levels for prognosis after modified radical mastectomy of breast cancer patients was superior to the net benefit rate predicted by them alone within the threshold of 0.2-0.6.Conclusion:The prognosis of patients with breast cancer after modified radical surgery is affected by the levels of serum E-Cad and HIF-1α before surgery，and the combined detection of the two has a high predictive value for the prognosis of patients with breast cancer after modified radical surgery.

Objective:To investigate the relationship between the expression of thymidine kinase 1(TK1) and cell proliferation antigen 67(Ki67) protein in cancer tissues and the prognosis of patients with differentiated thyroid carcinoma (DTC) treated by endoscopic assisted thyroidectomy via areola approach.Methods:In a case control study, 40 DTC patients with poor prognosis who received endoscopic resection via areola from June 2012 to June 2016 were included in the poor prognosis group. At the same time, 40 patients with DTC with good prognosis who received endoscopic resection via areola approach were included in the good prognosis group. All patients were followed up for 5 years. SPSS 23.0 software was used for data processing. The enumeration data were expressed as [cases (%)], and χ2 test was used. Rank sum test was used for grade data; all measurement data were tested by Shapiro-Wilk normality test, and the normal distribution was expressed as (). Independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as [M(P25, P75)], and Mann-Whitney U test was used for comparison between groups. The receiver operating curve (ROC) was drawn to analyze the relationship between the expression of TK1 and Ki67 protein and the prognosis of DTC patients after endoscopic resection via areola approach. P<0.05 was considered statistically significant.Results:The positive expression rate of TK1 and Ki67 protein in DTC cancerous tissues (66.25%, 71.25%) was higher than that in adjacent tissues (21.25%, 23.75%) (P<0.05); the levels of thyroglobulin (Tg) and thyroid stimulating hormone (TSH) in patients with poor prognosis were higher than those in patients with good prognosis, and the positive expression rates of TK1 and Ki67 protein were higher than those in patients with good prognosis (P<0.05). The ROC curve was drawn. The results showed that the AUC of TK1 and Ki67 protein expression predicting the poor prognosis of endoscopic resection via areola approach were 0.825 (95% CI: 0.728-0.922) and 0.863 (95% CI: 0.775-0.950), respectively, which had certain predictive value.Conclusion:The prognosis of DTC patients may be related to the expression of TK1 and Ki67 proteins in cancer tissues, and TK1 and Ki67 proteins can be used as prognostic indicators of DTC patients.

Objective:To explore the effects of tigacycline-based combination therapy on procalcitonin (PCT), high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in patients with multiple drug-resistant acinetobacterbaumannii post-operative abdominal infection in intensive care unit (ICU).Methods:Seventy-five patients with multiple drug-resistant acinetobacter baumannii post-operative abdominal infection in ICU admitted to West Central Hospital of Hainan Prorvincefrom October 2015 to October 2018 were selected and divided into the control group (37cases) and the observation group (38 cases) according to random number table method. The control group was treated with cefoperazone-sulbactam on the basis of routine treatment, while the observation group was treated with tegacycline on the basis of the control group. Both groups were treated for 1 week. The clearance of acinetobacterbaumannii and clinical efficacy of the two groups were counted; the levels of serum PCT, hs-CRP and IL-6 and ummune function were compared.Results:The clearance rate of acinetobacterbaumannii in the observation group was significantly higher than that in the control group: 76.32%(29/38) vs. 54.05%(20/37), χ2 = 4.10, P = 0.043. Compared with before treatment, the levels of serum PCT, hs-CRP and IL-6 in the two groups were decreased after 1 week of treatment, and the levels of serum PCT, hs-CRP and IL-6 in the observation group were lower than those in the control group ( P<0.05). Compared with before treatment, the levels of peripheral blood CD 3+, CD 4+, CD 4+/CD 8+ were increased and peripheral blood CD 8+ was decreased in both groups, and the levels of peripheral blood CD 3+, CD 4+, CD 4+/CD 8+ in the observation group were higher than those in the control group ( P<0.05), while the level of peripheral blood CD 8+ in the observation group was lower than that in the control group ( P<0.05). The total effective rate in the observation group was significantly higher than that in the control group: 89.47% (34/38) vs. 67.57% (25/37), χ2 = 4.13, P<0.05. Conclusions:Tigacycline combined with cefoperazone-sulbactam in the treatment of intra-abdominal infection after surgery of acinetobacterbaumannii in ICU could reduce the levels of serum PCT, hs-CRP, IL-6, reduce the body′s inflammatory response and improve the immune function, and improve the treatment efficiency of intra-abdominal infection.