OBJECTIVE To explore the diagnostic value of combined detection of plasma miR-127-3p and HE4 for breast cancer (BC). METHODS Included in this study were 102 patients with pathologically confirmed BC who received treatment in the affiliated hospital of Nantong University between March 2015 and April 2016, 87 patients with benign breast tumors, and 90 healthy volunteers as control. Plasma miR-127-3p was detected by SYBR Green RT-qPCR, and plasma HE4 was detected by chemiluminescent immunoassay. The diagnostic efficacy of miR-127-3p alone, HE4 alone and combined detection of miR-127-3p and HE4 in BC women patients was evaluated by ROC curve analysis. RESULTS The relative expression quantity (RQ) of plasma miR-127-3p and HE4 in BC patients was 13.561 (3.345∼18.281) pmol/L and 105.42 (40.28∼156.31) pmol/L. The RQ of plasma miR-127-3p in BC patients was significantly higher than that in benign breast tumor patients and healthy individuals (both P< 0.001), and there was no significant difference between benign breast tumor patients and healthy individuals (P> 0.05). There was no significant correlation between plasma miR-127-3p and HE4 levels (r2= 0.086, P= 0.471). ROC curve analysis on the diagnostic efficacy of plasma miR-127-3p and HE4 in BC diagnosis showed that the cut-off value of miR-127-3p and HE4 in BC diagnosis was 3.471 and 63.21 pmol/L; AUC was 0.767 and 0.670; sensitivity was 78.2% and 64.6%; specificity was 79.1% and 69.3%; accuracy was 73.2% and 65.1%, respectively. Prediction probability (P) obtained from the miR-127-3p and HE4 model established by logistic regression was P= 1/ [1 + exp (-0.142miR-127-3p-0.024HE4 + 2.875)]. AUC calculated from ROC was 0.825 and the sensitivity was increased to 87.4%. CONCLUSION Combined detection of plasma miR-127-3p and HE4 greatly improved the sensitivity of BC diagnosis and may prove to be a candidate biomarker for early detection and diagnosis of BC.

Objective To investigate the expression of human epididymal protein 4 (HE4) in chronic kidney disease (CKD) and its clinical value.Methods From April 2014 to December 2015,Serum samples of 92 non-cancer patients diagnosed as CKD and 84 healthy controls were collected in Nantong University Hospital.HE4,BUN,Scr,Cys C and β2MG were detected.The difference of HE4 expression in different stages of CKD and the correlation of HE4 with Urea,Scr,Cys C and β2MG were analysized,respectively.ROC curve was used to evaluate the auxiliary diagnostic value of HE4,BUN,Scr,Cys C and β2MG.Results The serum HE4 expression in patients with impaired renal function was 388.2 (130.1～1 659.5)mIu/ L,(F=16.237,P=0.001).Which was significantly higher than that in the control group [38.1 (32.77 ～ 48.17)mIu/L].The serum HE4 expression was increased by the stage of renal damage and the difference was existed among different groups (P＜0.05).HE4 expression was positive related with Cys C and β2MG.The AUC of HE4,BUN,Scr,Cys C and β2MG were 0.878,0.785,0.816,0.874 and 0.819,respectively.Conlusion It needs to consider the exsits of impaired renal function when the HE4 was detected.The HE4 might be a novel early diagnostic indication for CKD.

OBJECTIVE To explore the value of rheumatoid factor (RF), anti-cyclic citrullinated peptide (CCP) antibody, C-reactive protein (CRP), and the erythrocyte sedimentation rate (ESR) in the diagnosis of rheumatoid arthritis (RA). METHODS Using rate nephelometry, chemiluminescence microparticle immunoassay (CMIA), and Westergren sedimentation rate testing, we detected RF, anti-CCP antibody, CRP, and ESR in 134 patients with RA and 50 healthy control individuals. RESULTS We observed significant differences in RF, anti-CCP antibody, CRP, and ESR concentrations between the RA and control groups (P <.01). The sensitivity, specificity and accuracy in the diagnosis of RA were 91.0%, 74.4%, and 87.0%, respectively, for RF; 88.0%, 90.4%, and 88.1%, respectively, for anti-CCP antibody; and 90.2%, 83.3%, and 89.5%, respectively, for the detection of RA via the combination of RF and anti-CCP antibody. CONCLUSION Anti-CCP is more specific than the other parameters we reviewed for the diagnosis of RA. Combined detection of the 4 parameters is beneficial when confirming a diagnosis of RA.

Objective:To investigate the features of common viruses in acute lower respiratory infection(ALRI) among hospitalized children in Nantong during 2014. Methods:Swab samples were collected from 752 hospitalized children with ALRI. Seven common respiratory viruses, including influenza virus A and B (IVA A, IVA B), parainfluenza virus (PIVⅠ, PIVⅡ and PIVⅢ), respiratory syncytial virus (RSV) and adenovirus (ADV) were detected with direct immunofluorescence assay, and to make epidemiological analysis by detailed clinical data. Results:In 752 cases respiratory tract samples, there were 317 cases of positive samples (42.1%). Of these, the proportion of RSV (58.7%) was the highest, followed by PIV Ⅲ(18.9%). The positive rate of virus was different with age. The positive rate of tested viruses among the 0~6 months old in-fants (53.33%) and 6 months~1 year old infants (51.09%) were the highest. The positive rate of virus was different with season. The positive rate in Jan (53.63%), Mar (58.75%) and Dec (53.35%) were higher than other months. The positive rate in Jun (32.39%) is the lowest. The positive rate of virus was different with disease of acute lower respiratory infection. Among these, the positive rate of virus in bronchiolitis (62.50%) was highest, followed by asthmatic bronchitis (49.54%), bronchial asthma concurrent infection (45.94%), pneumonia (36.12%). The positive rate in bronchitis with no gasp (31.21%) was lowest. RSV was the major viral pathogen in each group of diseases. Conclusions:RSV is the predominant viral pathogen associated with ALRI in the hospitalized children in Nantong. 0~1 year old infants are the main infected popula-tion. The prevalence of these viruses exhibits the season-dependence and disease-dependence.

目的:探讨结直肠癌(colorectal cancer,CRC)患者外周血中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)以及血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)检测的临床应用价值.方法:运用XE-2100血细胞分析仪检测62例CRC患者外周血细胞参数,分别计算NLR和PLR,并以20例肠良性病变患者以及33例健康体检者作为对照进行比较分析.结果:(1)CRC组的NLR(4.36±1.28)及PLR(184.2±23.40)显著高于良性病变组和对照组(F=67.49、50.10,P＜0.01).(2)NLR的受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)下面积(area under the curve,AUC)为0.826,95％可信区间(confidence interval,CI)为0.753～0.885;灵敏度为70.6％,特异性为82.2％.PLR的ROC AUC为0.745,95％ CI为0.664～0.814;灵敏度为67.6％,特异性为74.0％.(3)NLR与CRC患者肿瘤大小以及TNM分期有关(P＜0.05);而与其他病理参数无关(P＞0.05).PLR仅与CRC患者TNM分期有关(P＜0.05);而与其他病理参数无关(P＞0.05).(4)动态检测CRC患者手术治疗前后NLR与PLR水平,二者均呈时间依赖性下降,治疗后与治疗前相比差异有统计学意义(F=19.82、9.78,P＜0.01).结论:CRC患者NLR及PLR明显增加,且二者与病情严重程度及恶性进展密切相关,可作为CRC患者临床诊疗及病情评估的指标.

Objective To establish the method of the SYBR Green Ⅰ real‐time fluorescent quantitative PCR for detecting the se‐rum miR‐203 expression level ,and to detect the serum miR‐203 expression levels in the patients with cervical cancer ,cervical benign diseases and healthy controls .Methods The miR‐203 ,U6 stem loop RT primers and the PCR amplification primers were designed for conducting fluorescence quantitative PCR ,with U6 as the internal relative quantification ,the serum miR‐203 levels were com‐pared among different cervical diseases .Results The established method could specifically detect the amplification signal of serum miR‐203 ,the melting curve was single and PCR products were specific .The serum miR‐203 level in the patients with cervical cancer was significantly higher than that in the patients with benign cervical diseases such as hysteromyoma and cervicitis ,the difference was statistically significant (P<0 .05) .Conclusion The SYBR Green Ⅰ real‐time fluorescent quantitative PCR is a quick ,simple detection method with high sensitivity and good specificity ,which may have a better application prospect in cervical cancer auxiliary diagnosis .

Objective:In the study, we clarity the combined detection of rheumatoid factor(RF)、anti-cyclic citrullinated peptide antibody(Anti-CCP) and anti-keratin antibody(AKA) in the diagnosis of rheumatoid arthritis(RA).Methods:132 patients with RA, 51 patients with other arthritis. RF was measured by immune rate nephelometry. Anti-CCP was measured by chemiluminescence immunoassay. Indirect Immunofluorescence assay was used to detect AKA.Results:The diagnostic sensitivity of RF for RA was 78.0% and the specificity was 64.7%. Whereas the diagnostic sensitivity of Anti-CCP for RA was 75.0% and the specificity was 88.2%. The diagnostic sensitivity of AKA for RA was 75.8% and the specificity was 86.3%. The combined detection of RF、Anti-CCP and AKA had a sensitivity of 63.6%% and the specificity of 96.1%.Conclusions:The results suggest that for diagnosis RA, the sensitivity of RF is better than Anti-CCP and AKA, whereas the specificity of Anti-CCP and AKA is better than RF. Combination of RF、Anti-CCP and AKA may be more helpful in early cliagnosis of RA patients.

Objective To compare differences among three precision evaluation methods by measuring serum glucose .Methods Two serum samples from two different medical decision level persons were collected as experimen-tal samples .Serum glucose level was measured by Advia2400 automatic biochemical analyzer .Precision evaluations were performed according to the variance analysis ,EP15-A2 document and EP5-A2 document .Calculate and com-pared the coefficient of variation (CV ) among the three methods .Results The CV of the two samples (low level and high level of serum glucose) for variance analysis were 0 .80% ,0 .73% .The CV of method carried out according to EP15-A2 document were 0 .81% ,0 .72% .The CV of the method carried out according to EP5-A2 document were 1 .25% ,1 .09% .All the CV were lower than national standard .The CV of the method carried out according to EP5-A2 document were superior to other two methods .Conclusion The precision carried out according to EP5-A2 docu-ment was significant higher than the results of variance analysis and the method carried out according to EP 15-A2 document .

目的探讨类风湿因子(RF)、抗环瓜氨酸肽抗体(抗-CCP)、C-反应蛋白(CRP)和红细胞沉降率(ESR)检测对类风湿性关节炎的诊断价值。方法利用速率散射免疫比浊和化学发光微粒子免疫检测法和Westergren法分别测定134例类风湿性关节炎(RA)患者和50例健康对照组的RF、抗-CCP、CRP和ESR水平。结果 RF、抗-CCP、CRP和ESR对RA诊断的阳性率分别为79.1%、74.6%、61.7%和82.9%。对RA诊断的灵敏度、特异度和准确度,RF分别为91.0%、74.4%和87.0%,抗-CCP分别为88.0%、90.4%和88.1%,将两者联合检测则分别为90.2%、83.3%和89.5%。结论 RF和抗-CCP是对RA诊断有较高灵敏度实验室血清学诊断指标,但抗-CCP对RA诊断有较高特异性;CRP和ESR尽管不是RA的特异性诊断指标,但对RA的辅助诊断也具有重要价值,四者同时检测有利于RA诊断。

目的:探讨脑损伤后β-1,4-半乳糖基转移酶-Ⅰ(β-1,4-galactosyltransferase-Ⅰ,β-1,4-GalT-Ⅰ)及其催化合成的β-1,4-半乳糖苷键(β-1,4-galactosylated carbohydrate,Galβ1-4GlcNAc)糖链与炎症的相关性.方法:运用免疫印迹法检测β-1,4-GalT-Ⅰ及Galβ1-4GlcNAc糖链在大鼠术后大脑皮质中的表达情况;采用免疫荧光双标,观察β-1,4-GalT-Ⅰ及Galβ1-4GlcNAc糖链在大脑皮质中的细胞定位.结果:大鼠脑损伤后,大脑皮质中β-1,4-GalT-Ⅰ及Galβ1-4GlcNAc糖链的表达水平呈现时间依赖关系,脑损伤后β-1,4-GalT-Ⅰ表达逐渐增加并持续在较高的水平,Galβ1-4GlcNAc糖链表达呈动态变化过程,在炎症早期上调达到高峰后有所降低.β-1,4-GalT-Ⅰ及其催化合成的Galβ1-4GlcNAc糖链主要定位于大脑皮质的活化的小胶质细胞中.结论:β-1,4-GalT-Ⅰ及其催化合成的Galβ1-4GlcNAc糖链在正常大脑皮质中仅有少量表达,脑损伤后两者表达均明显增高;术后高表达的β-1,4-GalT-Ⅰ主要定位于小胶质细胞,这提示该分子可能参与炎症介导的小胶质细胞的生物学行为的改变.

目的:探讨C-反应蛋白(CRP)在肝胆疾病诊断中的意义.方法:对185例肝胆疾病患者,同步检测其肝功能及CRP.结果:肝胆疾病患者的血清CRP水平与总胆红素(TBi)水平成直线正相关;胆系病变患者中CRP升高率高于病毒性肝炎(P＜0.01).结论:血清CRP测定有助于肝胆疾病的鉴别诊断.

系统性红斑狼疮(SLE)是常见的多系统损害的自身免疫性疾病,近年来的研究发现,T细胞亚群的平衡偏移在疾病的发生发展中有重要的意义.由于T细胞亚群的平衡偏移导致活化T细胞产生的细胞因子也发生偏移,从而诱导B细胞的异常增生,产生大量抗体,促进细胞毒性T细胞活化等一系列免疫效应性病理损伤[1],同时在SLE患者血清中可检测到主要由T辅助细胞分泌的细胞因子,如IL-2,IL-6等.这些特异性自身抗体及细胞因子均是SLE诊断的实验指标.为探讨SLE患者血清IL-6水平与自身抗体之间的关系,我们对55例SLE患者血清进行IL-6水平和抗ENA抗体谱检测.

Objective To establish a quick determination method of neurotransmitter amino acids of clinical patient cerebrospinal fluid(CSF).Methods 120 patient CSF samples were detected by capillary electrophorsis with laser-induced fluorescence.Results 4 neurotransmitter amino acids were separated on base line in 20 min.Linear range of calibration curves was during 0.1～50 μmol/L concentration,relative standard deviation(RSD) of peak time of mobility was 0.56%～2.06%,that of peak area 2.24%～3.79%.The recovery for 4 amino acid exceeded 98%.Conclusion Capillary electrophoresis with laser-induced fluorescence can be useful as a selective,rapid and sensitive tool for study of the mechanisms of these disorders.

Objective To investigate main influential factors for determination of neurotransmitter amino acids by capillary electrophoresis.Methods 4 neurotransmitter amino acids derivatized withFITC were determined by capillary electrophoresis.Buffer concentrations,pH,surfactants and derivatization conditions were studied and optimized for fast andefficient separation.Results The running buffer concentrations,pH,surfactants and derivatization conditions could be improved for the separating efficiency.4 neurotransmitter amino acids derivatized with FITC were separated on base line in the optimum condition of 75 mmol/L boric acid(pH 9.42)contanining 100 mmol/L SDS acting as running buffer and 50 mmol/L boric acid(pH 9.80) as derivatization buffer in 20 min.Conclusion Through optimization,the separating efficiency of capillary electrophoresis withlaser-induced fluorescence detecting 4 neurotransmitter amino acids can be remarkably improved.

对冠心病(CAD)与外周血白细胞(WBC)计数的关系探讨如下. 1对象和方法 1.1对象我院心内科2001～2005年经冠状动脉造影确诊为CAD患者105例,男72例,女33例,年龄42～78(66.5±9.4)岁.

目的:探讨缺血修饰白蛋白(IMA)对急性心原性胸痛的早期诊断价值。方法:研究91例急诊胸痛病人,分为ACS组(胸痛<6h)、AM I组(胸痛>6h)。分别测定IMA、肌钙蛋白(cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CK-M B)及记录ECG。结果:ACS组(胸痛<6h)、AM I组(胸痛>6h)IMA区间范围分别为84.6±4.2ABSU/m l,81.9±2.4ABSU/m l,与健康对照组62.0±5.5ABSU/m l相比,有显著性差异(P<0.05)。结论:IMA与常规检测方法相比,是诊断心原性胸痛的灵敏指标,但不能很好区分缺血与梗死。其灵敏度高,特异性较差,故其阴性预测价值更大。