Combined detection of AFP-L3, GP73 and TIP30 enhances diagnostic accuracy for HBV-related cirrhosis and hepatocellular carcinoma.

OBJECTIVE: To investigate the value of combined tests of serum Golgi protein-73, alpha-fetoprotein- L3 and Tat-interacting protein-30 in the diagnosis of hepatitis B virus related cirrhosis and hepatocellular carcinoma. METHODS: The cross-sectional study was conducted at Yuebei People's Hospital, Guangdong, China, from January to October 2017, and comprised hepatitis B patients and healthy controls. Serum Golgi protein-73, alpha-fetoprotein-L3 and Tat-interacting protein-30 levels in both groups were detected by enzyme-linked immunosorbent assay (ELISA). Alpha-fetoprotein-L3 was separated and quantified by electrochemiluminescence immunoas says and the percentage of alpha-fetoprotein-L3 to alphafetoprotein was calculated. RESULTS: Of the 721 subjects, 525(%) were patients and 196(%) were healthy controls. Among the patients, 271(%) had chronic hepatitis B, 161(%) had liver cirrhosis and 93(%) had hepatocellular carcinoma. Serum Golgi protein-73, alpha-fetoprotein-L3 and Tat-interacting protein-30 levels were significantly different in the hepatocellular carcinoma patients compared to controls, and those with chronic hepatitis and liver cirrhosis (p<0.01 each). The sensitivity and specificity of the combined detection of the three serum levels for diagnosing cirrhosis were 78.26% and 86.72%. The corresponding values for diagnosing hepatocellular carcinoma were 86.02% and 92.51%. CONCLUSIONS: Combined detection of Golgi protein-73, alpha fetoprotein-L3 and Tat-interacting protein was found to have the potential to improve diagnostic accuracy.

Application value of total abdominal CT examination in elderly patients with acute intestinal obstruction / 中国基层医药

Objective To explore the necessities and clinical value of acute intestinal obstruction with com-puted tomography of whole abdomen in over 80 years old patients.Methods 50 patients with acute intestinal obstruc-tion were diagnosed in department of emergency surgery and underwent the abdominal CT examinations.The clinical data,CT and surgery pathology of all patients were compared and analyzed.Results All cases were verified by surgi-cal operation and pathological diagnosis,including colorectal cancer(n =21)and incarcerated abdominal external her-nia(n =21),appendicitis(n =2),adhesive intestinal obstruction(n =2),intestinal volvulus (n =2),and intestinal intussusception(n =1)and stercoral intestinal obstruction(n =1),12 cases were accompanied by bowel necrosis and perforation.12 patients were treated by laparoscope surgery,38 cases by open laparotomy,48 patients acquired good recovery,and 2 cases died from extensive bowel necrosis and multi -organ failure.Conclusion CT examination in whole abdomen could rapidly and accurately diagnose the cause of intestinal obstruction,evaluate complications and risks,so as to provide reasonable treatment choice and time,making patients acquired the effective effects as soon as possible,reducing the bad consequences.

Selective application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy / 中华胰腺病杂志

Objective To analyze and summarize the efficacy and the experience in the application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy in pancreaticoduodenectomy. Methods Between Jan.2005 and Dec. 2009, a total of 38 patients who underwent bundled pancreaticojejunostomy was enrolled, and their clinical data were retrospectively analyzed. 20 patients received type Ⅰ bundled pancreaticojejunostomy and 18 patients received type Ⅱ bundled pancreaticojejunostomy. The operative time, postoperative hospital stay, mortality and complications were compared. Results The operative time of type Ⅰ bundled pancreaticojejunostomy was (91 ± 20) min, and it was (63 ± 21) min in type Ⅱ procedure, and the difference was statistically significant (P ＜ 0. 05). The mortality and complications, postoperative hospital stay were 10.0%(2/20), 45.0% (9/20) and (20 ±2)d in type Ⅰ procedure, while they were 5.6% (1/18),38.9% (7/18) and(23 ±2)d in type Ⅱ procedure, and the difference was not statistically significant.Conclusions There was no significant difference in the effects between type Ⅰ and type Ⅱ bundled pancreaticojejunostomy. Carefully selective application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy helps complete these procedures.