【摘要】 目的 〖JP2〗探討血管內皮生長因子（VEGF）聯合血清腫瘤標志物對肺癌早期診斷意義。 方法 2008年1月-〖JP〗2009年8月收治的92例患者中肺癌患者64例，采集靜脈血清標本采用酶聯免疫法檢測其VEGF水平。 結果 64例肺癌與28例非肺癌患者VEGF表達水平分別為（255.72±566.00）、（299.46±795.8） pg/mL，兩者比較無統計學意義（Pgt;0.05）；43例中晚期肺癌VEGF值（125.07±68.2） pg/mL，表達顯著高于12例早期肺癌（196.00±260.60） pg/mL （Plt;0.05）；CEA與CYFRA21-1的表達對判斷26例發生胸膜轉移的肺癌有統計學意義（Plt;0.05）。 結論 結合血清VEGF水平和常規腫瘤標志物，可評估現狀及臨床分期，VEGF結合CEA與CYFRA21-1表達水平為預測肺癌患者早期發生胸膜轉移提供理論依據。【Abstract】 Objective To evaluate the effect of combined detection value of serum vascular endothelial growth factor (VEGF) and tumor markers on early diagnosis of lung cancer. Method Intravenous serum levels of VEGF and tumor markers were assayed by ELISA in 92 patients including 64 lung cancer from January 2008 to August 2009. Results The difference in serum levels of VEGF between the 64 patients with lung cancer [(255.72±566.0) pg/mL] and 28 health adult [(299.46±795.8) pg/mL] was not significant (Pgt;0.05). The level of VEGF in 43 patients with middle and late lung cancer [(125.07±68.2) pg/mL] was significantly higher than that in the 12 patients with early lung cancer [(196.00±260.60) pg/mL] (Plt;0.05). There were statistical significance in expression of serum CEA and CYFRA21-1 on diagnosis in 26 patients having lung cancer with early metastasis pleural fluid (Plt;0.05). Conclusion Combined diagnostic of serum VEGF and tumor markers can assess the state of an illness and clinical stage, and the serum levels of serum VEGF,CEA and CYFRA21-1 may be a good predictor for lung cancer with early metastasis pleural fluid.
ObjectiveTo investigate the clinical significancy of K-ras gene mutation in peripheral blood free DNA in patients with non-small cell lung cancer (NSCLC). MethodsA total of 242 patients pathologically diagnosed with NSCLC in the Third People's Hospital of Chengdu were recruited between January 2013 and August 2015. Both tumor tissues and peripheral blood free DNA were collected for detection of K-ras gene mutation by mutant-enriched liquidchip technology. The detection rate was compared between these two kinds of samples. ResultsIn tumor tissues, the K-ras gene mutation was detected in 12 cases with a positive rate of 4.96%. While in peripheral blood samples, the K-ras gene mutation was detected in 10 cases with a positive rate of 4.13%. The detection yield of K-ras gene mutation in peripheral blood had a good consistency with that of lung cancer tissues (Kappa value=0.81). ConclusionK-ras in peripheral blood plasma free DNA can be a surrogate marker for tumor tissues' K-ras gene mutation in screening patients with NSCLC.
目的 探討慢性阻塞性肺疾病急性加重（AECOPD）合并肺栓塞（PE）的臨床特點。 方法 回顧性分析2009年1月－2012年6月38例AECOPD合并PE患者（栓塞組）的臨床資料，并與42例單純AECOPD（對照組）臨床資料進行對比。 結果 栓塞PE組不對稱性下肢水腫發生率明顯高于對照組（P＜0.05），另外肺動脈高壓、D-二聚體及修改的Geneva評分與對照組比較存在一定差異，且差異有統計學意義（P＜0.05）。 結論 AECOPD合并PE的臨床表現并不特異，當AECOPD出現不對稱性水腫、D-二聚體升高、肺動脈高壓及修改的Geneva評分升高等表現不能解釋原因時，要考慮PE的可能，并盡快選擇CT肺動脈成像或肺動脈造影以明確診斷。
ObjectiveTo investigate diagnostic and prognostic value of pulmonary embolism severity index (PESI), troponin I (cTnI) and brain natriuretic peptide (BNP) in patients with acute pulmonary embolism (APE). MethodsA total of 96 patients confirmed with APE were collected from January 2010 to January 2013, and 50 cases of non-APE controls were also selected in the same period. According to the PESI scores, patients were divided into low-risk, mid-risk, and highrisk group. According to the results of cTnI and BNP, patients were divided into positive group and negative group. Then, we evaluated the diagnostic and prognostic value of the PESI score, cTnI and BNP for patients with APE. ResultsFor the APE patients, the higher the risk was, the higher the constituent ratio of massive and sub-massive APE was (P<0.01). In the cTnI positive group, massive and sub-massive APE accounted for 82.9%, and in the cTnI negative group, non-massive APE was up to 81.9%; in the BNP positive group, massive and sub-massive APE accounted for 73.3%, and in the BNP negative group, non-massive APE was up to 86.3%. The patients with positive cTnI and BNP had a higher rate of right ventricular dysfunction, cardiogenic shock and mortality than the negative group (P<0.01). ConclusionThe combined detection of cTnI, BNP and PESI score is important in the diagnosis and risk stratification in APE patients.
【Abstract】 Objective To survey the prevalence and risk factors of chronic obstructive pulmonary disease ( COPD) , and establish database for community intervention of COPD.Methods A cluster-randomsampling survey was carried out. The population aged over 40 years old in eight communities of Chengdu were investigated from August 2007 to August 2009 using the standard protocol and questionnaire. The spirometry was performed for each participant. Results A total of 4315 residents were enrolled in this survey and 3687 case reports were analyzed, including 1529 males and 2148 females, with an average age of 60. 35 ±13. 21 years old. Total prevalence of COPD was 9. 6% . The prevalence of COPD in the males was significantly higher than that in the females ( 14. 0% vs. 6. 4%, P lt;0. 01) . The prevalence of COPD increased with the age. The major risk factors were cigarettes smoking ( OR = 3. 012, 95% CI 2. 390-3. 797, P lt; 0. 01) and indoor cooking smoking ( OR = 2. 546, 95% CI 1. 734-3. 425, P lt; 0. 01) . Conclusion The prevalence of COPD in Chengdu city is significantly higher than average level of the whole country, which warrant moreattention to better prevention and treatment of COPD in communities.
Objective To survey the prevalence of coexisting chronic obstructive pulmonary disease ( COPD) and chronic heart failure in Chengdu communities. Methods A cross-sectional study was performed in the population aged over 40 years in eight communities of Chengdu city. The subjects were selected by stratified cluster random sampling. Using the same protocol and questionnaire, all participants underwent medical history taking, physical examination and spirometry. Results Of 354 participating patients with a diagnosis of COPD, 74 ( 20. 90% ) cases were complicated with chronic heart failure. The prevalence of chronic heart failure in COPD in male was significantly higher than that in female ( 22. 69%vs. 18. 12% , P lt; 0. 05) . The major causes of chronic heart failure were hypertension ( 31. 64% ) , ischaemic heart disease ( 18. 93% ) , chronic pulonary heart disease ( 17. 51% ) and diabetes ( 11. 86% ) .Conclusions The prevalence of coexisting COPD and chronic heart failure in Chengdu city is significantly higher than the average level of the whole country, which warrant more attention in prevention and treatment of COPD in communities.