[Clinical safety and efficiency of ultrasonic bone curette used in anterior cervical discectomy and fusion surgery]

Objective: To investigate the safety and efficiency of ultrasonic bone curette used in anterior cervical discectomy and fusion surgery. Methods: As a retrospective study, we collected and analyzed the clinical data of 47 patients receiving anterior cervical discectomy and fusion surgery in Luohe Central Hospital from January 2014 to January 2017, there were 26 males and 21 females with a mean age of (52±9) years. According to the different surgical tools used in the process of decompression by resecting osteophytes or bone like an inverted Chinese character "" located at the posterior margin of the vertebral body, the patients were divided into two groups: ultrasonic bone curette group (group A) and traditional tools group (group B). The operating time, volume of intraoperative blood losing, complications, Japanese Orthopedic Association (JOA) score before and after the operation and improvement rate were recorded in the two groups. The t test was used to compare the data between the two groups. Results: In group A, the operating time was (47±7) min, blood loss was (49±4) ml, 1 case experienced urinary tract infection and there was no cerebrospinal fluid leakage or spinal cord injury. In group B, the operating time was (54±12) min and the blood loss was (117±16) ml, cerebrospinal fluid leakage occurred in 2 patients and the incision healed one-stage by local compression, hoarseness happened in 1 case and it disappeared after 2 weeks, 2 patients had swallowing discomfort and recovered in one month, no spinal cord injury occurred in this group. The operating time and blood loss in group A were lower than those in group B (t=2.691, 20.704, both P<0.05). And the incidence of complications in group A were lower than that in group B (χ(2)=4.157, P=0.041). The JOA score of group A at 3 days after surgery was improved for 39.0% when compared with that before the surgery, and it was improved for 71.6% at one year after the surgery. The JOA score in group B at 3 days after surgery was elevated for 38.7% from that before the surgery, and it increased for 69.4% at one year after the surgery. There was no significant different in JOA score before the surgery, 3 days and one year after the surgery between the two groups (t=0.611, 1.076, 0.061, all P>0.05). Conclusion: In the process of decompression by resecting osteophytes or bone located at the posterior margin of the vertebral body in the anterior cervical discectomy and fusion surgery, ultrasonic bone curette is safe and effective, and it can effectively shorten the operating time, decrease the blood loss and cut down the incidence of complications.

Comparison of hand-sewn versus modified coupled arterial anastomoses in head and neck reconstruction: a single operator's experience

Microvascular coupler devices have gained wide acceptance as an alternative to the traditional hand-sewn technique in reconstructive surgery. However, no study has directly compared the efficacy of the coupler and hand-sewn techniques in arterial anastomosis during head and neck reconstruction surgery. A total of 123 patients who underwent surgery performed by a single surgeon between 2016 and 2018 were included in this retrospective study. The patients were divided into the coupler group and the hand-sewn group according to the technique of arterial anastomosis used. Patients in the coupler group underwent a special procedure including arterial bifurcation to enlarge the recipient artery diameter. Of the 123 free flap surgeries performed, 56 were done using a coupler and 67 with the standard suture technique. One flap in the coupler group failed due to simultaneous arterial and venous thromboses. One flap in the hand-sewn group was lost due to venous compromise. The overall flap survival rate was 98.4% (n=121). There was a significant decrease in anastomotic time when a coupler was used (P<0.001). The complication and flap loss rates were similar in the coupler and hand-sewn groups. The application of the coupler helped to decrease the anastomotic time and achieved satisfactory vessel patency.

Direct investigation of current transport in cells by conductive atomic force microscopy

Currents play critical roles in neurons. Direct observation of current flows in cells at nanometre dimensions and picoampere current resolution is still a daunting task. In this study, we investigated the current flows in hippocampal neurons, PC12 cells and astrocytes in response to voltages applied to the cell membranes using conductive atomic force microscopy (CAFM). The spines in the hippocampal neurons play crucial roles in nerve signal transfer. When the applied voltage was greater than 7.2 V, PC12 cells even show metallic nanowire-like characteristics. Both the cell body and glial filaments of astrocytes yielded CAFM test results that reflect different electrical conductance. To our best knowledge, the electrical characteristics and current transport through components of cells (especially neurons) in response to an applied external voltage have been revealed for the first time at nanometre dimensions and picoampere current levels. We believe that such studies will pave new ways to study and model the electrical characteristics and physiological behaviours in cells and other biological samples.

One-Step Growth of Amorphous/Crystalline Ga2O3 Phase Junctions for High-Performance Solar-Blind Photodetection

The pursuit of high-performance photodetectors functioning in the solar-blind spectrum is motivated by both scientific and practical applications ranging from secure communication, monitoring, sensing, etc. In particular, the fabrication of heterojunctions based on the wide band gap semiconductors has emerged as an attractive strategy to promote the high-efficient photogenerated electron/hole pair separation. However, the precisely controlled growth of heterojunctions remains a huge challenge. The lattice mismatch leads to the formation of defects and/or dislocations at the interface, deteriorating the performance of devices and limiting their envisioned applications. Here, we demonstrate a simple one-step growth of amorphous/crystalline Ga₂O₃ phase junctions by using sputtering technique, yielding a large responsivity of 0.81 A/W, a superior photo-to-dark current ratio over 10⁷, and an ultrahigh response speed of ∼12 ns. Compared to the previous reported solar-blind photodetectors, the obtained detectivity ≈ 5.67 × 10¹⁴ Jones is increased by 2 orders of magnitude. Such excellent photoresponse characteristics can be understood by the interfacial built-in field-promoted electron/hole pair separation for the amorphous/crystalline Ga₂O₃ phase junctions. Our results provide a novel path toward realizing high-performance optoelectronics functioning in the solar-blind spectrum.

Oral vaccination with the porcine circovirus type 2 (PCV-2) capsid protein expressed by Lactococcus lactis induces a specific immune response against PCV-2 in mice

AIMS

Porcine circovirus type 2 (PCV2) can cause postweaning, multisystemic wasting syndrome in pigs, which leads to enormous losses in the swine industry worldwide. Here, a genetically engineered Lactococcus strain expressing the main protective antigen of PCV2, the Cap protein, was developed to act against PCV2 infection as an oral vaccine.

METHODS AND RESULTS

Expression of the Cap protein was confirmed via western blot, ELISA and fluorescence microscopy. Over 90% of the recombinant pAMJ399-Cap/MG1363 survived a simulated gastrointestinal transit. It also survived the murine intestinal tract for at least 11 days. Then, the safety and immunogenicity of pAMJ399-Cap/MG1363 in orally immunized mice was evaluated. The levels of the sIgA, IgG and cytokines (IL-4 and IFN-γ) obtained from the mice immunized with pAMJ399-Cap/MG1363 were significantly higher than those in the control groups.

CONCLUSIONS

pAMJ399-Cap/MG1363 can survive in the gastrointestinal transit and effectively induce mucosal, cellular and humoral immune response against PCV2 infection via oral administration.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study demonstrates the potential of the genetically engineered Lactococcus lactis as a candidate for an oral vaccine against PCV2.

Effects of Lactococcus lactis MG1363 producing fusion proteins of bovine lactoferricin-lactoferrampin on growth, intestinal morphology and immune function in weaned piglet

AIMS

We developed a strategy for localized delivery of the LFCA (lactoferricinlactoferrampin), which is actively synthesized in situ by Lactococcus lactis (pAMJ399-LFCA/LLMG1363), and explored the possibility of using pAMJ399-LFCA/LLMG1363 as an alternative additive diet to antibiotics.

METHODS AND RESULTS

The antimicrobial activities of the LFCA derived from pAMJ399-LFCA/LLMG1363 were tested in vitro. The results showed that LFCA had an inhibitory effect on Staphylococcus aureus, Escherichia coli and Salmonella enteritidis. Then, the pAMJ399-LFCA/LLMG1363 was used as an additive diet for piglets. Our data demonstrated that oral administration of pAMJ399-LFCA/LLMG1363 significantly improved the average daily gain, feed-to-gain ratio, intestinal mucosal integrity and decreased the serum endotoxin and d-lactic acid levels. The mRNA expression levels of intestinal tight junction proteins (including occludin, Claudin-1 and ZO-1) were significantly upregulated by pAMJ399-LFCA/LLMG1363 administration. The serum immunoglobulin G (IgG) levels, intestinal secretory immunoglobulin A (sIgA) levels, IL-2, IL-10 and TGF-β levels were significantly increased by pAMJ399-LFCA/LLMG1363. Furthermore, our data revealed that oral administration of pAMJ399-LFCA/LLMG1363 significantly increased the number of general Lactobacillus, and decreased the total viable E. coli counts in the ileum and cecum contents.

CONCLUSIONS

We developed a novel pAMJ399-LFCA/LLMG1363 secreting LFCA, which had probiotic effects on the growth performance, intestinal morphology, intestinal barrier function and immunological indices of weaned piglets.

SIGNIFICANCE AND IMPACT OF THE STUDY

pAMJ399-LFCA/LLMG1363, with probiotic effects on the health of weaned piglets, may be a promising feed additive for weaned piglets.

[Results for the treatment of fresh type thoracolumbar vertebral fracture according to the intraoperative CT scan]

Objective: To evaluate the value of intraoperative CT scanning in the treatment of fresh thoracolumbar burst fractures. Methods: From January 2008 to January 2015 , 161 patients with thoracolumbar fractures in Department of Orthopedics, Luohe City Central Hospital, were divided into two groups: 79 cases were treatment group which were treated with intraoperative CT scan and decompression mode was determined according to CT scan results during the period from October 2012 to January 2015. 82 patients as the observation group were treated without intraoperative CT scan and direct laminectomy were performed during the period. In the treatment group, it is no further decompression of the spinal canal when the CT showed a reduction of the fracture block into the spinal canal, if the intraoperative CT showed that the fractures still occupied the spinal dura mater according to the three-dimensional CT information, the position and the size of the fracture of the spinal canal were determined, and the unilateral laminectomy was performed corresponding to the position of the lamina and intervertebral ligamentum flavum. The operative time, bleeding volume, neurological function, height of the anterior vertebral compression and Cobb angle were compared between the two groups. Results: In the treatment group, CT scan showed 48 cases (60.8%) entered the spinal canal fracture completely or basically reset.31 cases (39.2%) still occupied the spinal canal compression spinal dura mater. There were significant differences in the operation time and bleeding volume between the two groups. The treatment group was less than the control group. There was no infection, secondary spinal cord injury, loose fixation and other complications. There was no difference in the ASIA classification before and after operation(χ(2)=0.268 vs χ(2)=1.372, P>0.05). The anterior vertebral height and COBB angle of the two groups were significantly improved compared with those before operation. There was no significant difference between the two groups in the postoperative height and COBB angle[(40.3±11.8)° vs(82.1±4.2)°, (-10.3±2.6)° vs(6.9±3.3)°, P<0.05], but after 2 years the difference was statistically significant between the two groups, to retain the rear ligament complex treatment group was significantly better than the control group. Conclusions: Patients of thoracolumbar vertebral fracture in hyperextension position combined with internal fixation can achieve good correction effect. Orthopedic postoperative CT scan and according to the results of the scan precision treatment can simplify the operation, there was no difference in clinical efficacy compared with total laminectomy, but some patients avoid the spinal canal decompression and part were treated by small fenestration laminectomy decompression, which is conducive to the protection of spinouts ligament complex integrity.

[Research progress on non-coding RNAs in the molecular pathogenesis of hepatocellular carcinoma]

Primary liver cancer arises from chronic liver disease, and cirrhotic liver gradually develops into dysplastic nodules that eventually form malignant tumors. In recent years, molecular biotechnology development has deepened people's understanding on the pathogenesis of liver cancer. Epigenetic modifications play a significant role in DNA methylation, non-coding RNAs, chromatin remodeling, and histone modification. This review focuses on the progress of currently implicated non-coding RNAs in the molecular pathogenesis of hepatocellular carcinoma, and its potential application in improving the diagnosis and treatment.

[Comparison of percutaneous endoscopic lumbar discectomy versus transforaminal lumbar interbody fusion in treating upper lumbar disc herniation]

Objective: To compare the efficacy of percutaneous endoscopic transforaminal discectomy (PTED) and transforaminal lumbar interbody fusion (TLIF) in the treatment of high lumbar disc herniation. Methods: The clinical data of patients with high lumbar disc herniation from February 2010 to February 2015 were retrospective analyzed. According to the inclusion criteria, a total of 63 cases were enrolled, including PTED group 33 cases, TLIF group 30 cases. The improvement of the two groups before and after surgery was assessed by visual analogue scale (VAS) and Oswestry dysfunction index (ODI). The operative time, intraoperative blood loss, drainage volume at 48 h postoperatively, hospitalization time, number of fluoroscopy, complication, recurrence rate and postoperative recovery were compared between the two groups. The follow-up period was 12 to 33 months. Results: The operation time, intraoperative blood loss, drainage amount and hospitalization time in PTED group were significantly less than those in TLIF group[(71±19) vs (121±22) min, (30±21) vs (317±50) ml, 0 vs (93±29) ml, (3.5±1.9) vs (12.5±2.1) d]. The number of fluoroscopy in PTED group was significantly higher than TLIF group[(16.2±8.3) vs (6.7±4.2)](all P<0.05). There was no significant difference in VAS score and ODI improvement rate between the two groups after operation (both P>0.05). There was no significant difference between the two groups in the excellent rate of surgery and the recurrence rate (both P>0.05). Conclusions: PTED has the advantages of less trauma and bleeding, rapid postoperative recovery in the treatment of upper lumbar disc herniation compared with TLIF, and the curative effect and recurrence rate are similar with TLIF. Therefore, PTED is an effective method for the treatment of upper lumbar disc herniation.

[Clinical observation of postprandial hypotension in patients with hypertensive and coronary heart disease]

Objective: To explore the prevalence and clinical characteristics of postprandial hypotension(PPH) in patients with essential hypertension and coronary heart disease. Methods: A total of 197 patients with essential hypertension and coronary heart disease, who had been treated in the First Department of Cardiology of the Second Hospital of Hebei Medical University from December, 2013 to December, 2014 were included. The patients' blood pressure before breakfast, lunch and dinner and 30, 60, 90, 120 minutes after the meal were monitored. Subjects were classified into PPH group (n=37) and non-PPH group (NPPH, n=160) according to postprandial decrease in systolic blood pressure, to explore the clinical characteristics and related factors and the major adverse cardiac and cerebral vascular events of PPH. Results: Among 197 patients, 37 cases (18.8%) showed at least once postprandial decline in systolic blood pressure greater than and equal to 20 mmHg. The incidence of PPH after breakfast and dinner were higher than lunch (P<0.05). There was no significant difference in the incidence of PPH among different age groups, among patients accompanied with different diseases, and among patients with different dining position (all P>0.05). According to the baseline systolic blood pressure, patients can be divided into 4 groups(<120 mmHg, 120-129 mmHg, 130-139 mmHg, >140 mmHg), the higher the level of the baseline systolic blood pressure was, the higher the incidence of PPH was. And the incidence of major adverse cardiac and cerebral vascular events in patients during hospitalization were increased by PPH. Conclusions: The prevalence of PPH in the patients with essential hypertension and coronary heart disease is 18.8%. The incidence of PPH after breakfast and dinner is higher than lunch. The baseline systolic blood pressure is considered to be the risk factor of PPH. And PPH could lead to an increase of the incidence of major adverse cardiac and cerebral vascular events.

Stabilization of warfarin-binding pocket of VKORC1 and VKORL1 by a peripheral region determines their different sensitivity to warfarin inhibition

Essentials VKORL1 and VKORC1 have a similar overall structure and warfarin-binding pocket. A peripheral region stabilizing this pocket controls warfarin sensitivity of the VKOR paralogs. A human single nucleotide polymorphism in this region renders VKORL1 sensitive to warfarin. A group of warfarin-resistant mutations in VKORC1 acts by disrupting peripheral interactions.

SUMMARY

Background The human genome encodes two paralogs of vitamin-K-epoxide reductase, VKORC1 and VKORL1, that support blood coagulation and other vitamin-K-dependent processes. Warfarin inhibits both enzymes, but VKORL1 is relatively resistant to warfarin. Objectives To understand the difference between VKORL1 and VKORC1, and the cause of warfarin-resistant (WR) mutations in VKORC1. Methods We performed systematic mutagenesis and analyzed warfarin responses with a cell-based activity assay. Mass spectrometry analyses were used to detect cellular redox state. Results VKORC1 and VKORL1 adopt a similar intracellular redox state with four-transmembrane-helix topology. Most WR mutations identified in VKORC1 also confer resistance in VKORL1, indicating that warfarin inhibits these paralogs at a common binding site. A group of WR mutations, distant from the warfarin-binding site, show significantly less resistance in VKORL1 than in VKORC1, implying that their different warfarin responses are determined by peripheral interactions. Remarkably, we identify a critical peripheral region in which single mutations, Glu37Lys or His46Tyr, drastically increase the warfarin sensitivity of VKORL1. In the background of these warfarin-sensitive VKORL1 mutants, WR mutations showing relative less resistance in wild-type VKORL1 become much more resistant, suggesting a structural conversion to resemble VKORC1. At this peripheral region, we also identified a human single nucleotide polymorphism that confers warfarin sensitivity of VKORL1. Conclusions Peripheral regions of VKORC1 and VKORL1 primarily maintain the stability of their common warfarin-binding pocket, and differences of such interactions determine their relative sensitivity to warfarin inhibition. This new model also explains most WR mutations located at the peripheral regions of VKORC1.

Optimization of Growth Temperature of β-Ga₂O₃ Thin Films for Solar-Blind Photodetectors

Monoclinic gallium oxide thin films were deposited on c-plane sapphire substrates at various substrate temperatures ranging from 450 °C to 700 °C by radio frequency magnetron sputtering technology. X-ray diffraction results showed that the deposited β-Ga2O3 films were oriented at ( 2 ¯ 01) direction. As the substrate temperature increased, the intensity of β-Ga2O3 peaks increased and bandgap decreased accordingly. Metal/semiconductor/metal structured solar-blind photodetectors based on β-Ga2O3 thin films growing at various substrate temperatures had been fabricated. The growth temperatures of thin films had no obvious influence on dark current and response to 365 nm light illuminations. The photoelectric properties such as responsivity and response speed of the thin films to 254 nm light illuminations were growth temperature dependent. At an applied bias of 50 V, the photodetectors prepared with 450 °C grown film had the highest responsivity of 2.18 A/W, and the photodetectors prepared with 700 °C grown film had the shortest rising time of 0.95 s under 254 nm light illuminations.

Electrical and Optical Properties of In₂O₃ Thin Films Deposited on Sapphire Substrate

In2O3 thin films were prepared on c-plane sapphire substrates using laser molecular beam epitaxy technique. The X-ray diffraction (XRD) patterns revealed that the In2O3 thin films were highly oriented along the (111) direction. The intensity of (222) diffraction peaks mainly depend on growth temperature, and the crystallite sizes mainly depend on oxygen pressure. The carrier concentrations exhibit a decrease with increasing growth temperature and oxygen pressure, meantime, the resistivity increase. The red shift of In2O3 thin films respect to that of bulk In2O3 can be explained by defect energy levels formation, the blue shift of In2O3 thin films depends on carrier concentration, can be explained by Burstein-Moss band-filling effect.

Association of Serum 25(OH) D Levels with Infarct Volumes and Stroke Severity in Acute Ischemic Stroke

BACKGROUND

The aim of this study is to investigate whether 25-hydroxyvitamin D [25(OH) D] is associated with initial stroke severity and infarct volume, using diffusion-weighted imaging (DWI) in patients with acute ischemic stroke.

METHODS

We studied a total of 235 patients who were admitted within 24 hours of acute ischemic stroke onset. Initial stroke severity was assessed using the NIH Stroke Scale (NIHSS) score. Infarct volume was measured using DWI. Multivariable linear and logistic regression analyses were used to test whether 25(OH) D represents an independent predictor of infarct volume and stroke severity (NIHSS score of ≥6).

RESULTS

Among 235 study patients, the median age was 64 years (IQR 56-75 years), and 125 (53.2%) were women. In multivariable models adjusted for other significant risk factors, 25(OH) D levels in the lowest and second interquartiles were associated with an increased risk of a NIHSS≥6 (with highest 25 (OH) D quartile as reference) with odd ratios (OR) 3.02(95% confidence interval [CI]:1.59-6.34) and 5.85(2.90-11.54). The median DWI infarct volumes for the serum 25(OH) D level quartiles (lowest to highest) were 12.35, 6.55, 2.44, and 1.59 ml. The median DWI infarct volume in the lowest serum 25(OH) D level quartile was larger than that in the other 3 quartiles (P<0.001). The median adjusted DWI infarct volume in the lowest serum 25(OH) D level quartile was statistically significantly larger than that in the other 3 quartiles (P<0.01).

CONCLUSION

In conclusion, reduced serum 25(OH) D levels in acute ischemic stroke are an early predictor of larger volumes of ischemic tissue and worse neurological deficit (assessed by the NIHSS).

[Impact of Myocardial Infarction and Abnormalities of Cardiac Conduction System on Sudden Cardiac Death]

Sudden cardiac death （SCD）, most commonly seen in coronary heart disease, is a kind of sudden death caused by series of cardiac parameters, which usually combines with myocardial infarction. However, some SCDs （including early myocardial infarction） happen suddenly and cause death in a very short time. In these circumstances, typical morphological changes are lack in macroscopic or microscopic fields, which make such SCDs become the emphasis and difficulty in the present research. SCD caused by myocardial infarction and abnormalities of cardiac conduction system （CCS） is related to atherosclerosis of coronary artery closely. This paper reviews cardiac dysfunction caused by myocardial infarction and diseases of CCS from morphology and molecular biology, and explores potential relationship between them. This paper aims to provide clues to the mechanism of myocardial infarction related sudden death and possible assistance for forensic diagnosis of SCD.

Oleanolic acid alleviates diabetic rat carotid artery injury through the inhibition of NLRP3 inflammasome signaling pathways

The overexpression of inflammasome components is correlated with diabetes‑associated complications. Oleanolic acid is a triterpenoid compound which is important in arterial injury. The present study evaluated whether oleanolic acid improved diabetic rat carotid artery injury through the inhibition of nucleotide‑binding domain, leucine‑rich‑containing family, pyrin domain‑containing‑3 (NLRP3) inflammasomes signaling pathways. A diabetic rat model was induced using streptozotocin (60 mg/kg) and underwent carotid artery injury. Morphometric analysis was performed using hematoxylin and eosin staining. The mRNA and protein levels were assayed by reverse transcription‑quantitative polymerase chain reaction and western blotting, respectively. It was found that oleanolic acid (100 mg/kg/day) improved body weight, glucose metabolic disorders, neointimal hyperplasia and endothelial dysfunction in diabetic rats with carotid artery injury. In addition, oleanolic acid administration significantly downregulated the mRNA and protein expression levels of endothelin 1 in diabetic rats. Oleanolic acid decreased the intimal area and the ratio of neointima to media in diabetic rats. Serum levels of tumor necrosis factor‑α, interleukin (IL)‑1β, IL‑6 and IL‑18 in the oleanolic acid‑treated diabetic rats were downregulated. Consistent with the serum results, it was demonstrated that oleanolic acid administration caused a significant decrease in the levels of NLRP3, caspase‑1 and IL‑1β in the carotid arteries of diabetic rats. Taken together, these observations suggested that oleanolic acid attenuated carotid artery injury in diabetic rats and the underlying mechanism was mediated, at least partially, through the suppression of NLRP3 inflammasome signaling pathways.

[The clinicopathological associations between TGF-β1 and papillary thyroid carcinoma: a Meta-analysis.]

Objective:To comprehensively evaluate the association between the positive expression rate of transforming growth factor beta 1 (TGF-β1) and papillary thyroid carcinoma (PTC) by using Meta-analysis.Method:Search the CNKI, Wan fang, VIP and PubMed database for accumulating papers studying on the relationship between the positive expression of TGF-β1 and PTC in Chinese and English. Revman 5.3 was used to analyze the included trials.Result:A total of 6 studies comprising 617 samples was included in the meta-analysis. The TGF-β1 were found in 243 patients (64.63%) of 376 PTC patients, and the total positive expression rate is 46.19%. Performing the subgroup analysis according to age, gender, lymphatic metastasis and TNM, the results showed that there was a significant association between the positive expression rate of TGF-β1 and lymphatic metastasis (OR=5.44, 95%CI3.31-8.93,P <0.000 01).Conclusion:This meta-analysis confirmed significant associations between the expression of TGF-β1 and PTC with lymph node metastasis. TGF-β1 may be used as a predictive factor for prognosis of PTC with lymph node metastasis.

[Establishment of cut-off value of serum pro-gastrin-releasing peptide for diagnosis of small cell lung cancer and evaluation on the clinical diagnosis efficiency]

Objective: To determine critical reference value (cut-off value) of serum pro-gastrin-releasing peptide (ProGRP) and neuron specific enolase(NSE) in the diagnosis of small cell lung cancer(SCLC). To evaluate the clinical significance of serum levels of ProGRP and NSE in diagnosis and differential diagnosis in SCLC. Methods: Three hundred and fifty-two SCLC patients, 163 non small cell lung cancer(NSCLC)patients , 193 benign pulmonary disease patients and 140 healthy people visiting in National Cancer Hospital were analyzed retrospectively from January 2014 to July 2017.The levels of serum ProGRP and NSE of people were determined using electrochemiluminescent immunoassay respectively . Reference value ranges of the makers were determined by using the method of ROC curves. Results: In NSCLC group, benign lung disease group, healthy control group and mixed group (NSCLC+ lung benign diseases+ healthy control group) as a reference, the cut-off values were 58.3, 62.3, 57.8, 61.3 ng/L. In the diagnosis and differential diagnosis of SCLC and NSCLC, benign lung diseases, healthy controls and mixed group, AUC of ProGRP was 0.940 (0.919-0.961), 0.941 (0.921-0.960), 0.959 (0.944-0.975), 0.946 (0.928-0.963) respectively. The sensitivities of ProGRP were 86.4%, 84.9%, 86.4% and 84.7% respectively. The specificities of ProGRP were 95.7%, 96.9%, 99.3%, 98% respectively. In all groups the Youden's index of ProGRP and NSE were 0.821 vs 0.612, 0.818 vs 0.674, 0.857 vs 0.810, 0.827 vs 0.674. In healthy controls, no statistically significant difference was found between ProGRP and NSE (P>0.05) in the diagnosis of AUC. However, in the remaining 3 groups, the ProGRP diagnosis of AUC was significantly greater than that of NSE (P<0.01). Compared with single marker detection, the sensitivity of combined detection of ProGRP and NSE in diagnosis of SCLC increased to 95.5%, 94%, 96.6% and 94% in each group. There was no significant difference between ProGRP and ProGRP+ NSE in the diagnosis of AUC when compared with the NSCLC group and the mixed group (P>0.05). However, when combined with a healthy control group and a benign lung disease group, the ProGRP+ NSE combination was the highest for AUC diagnosis, compared with ProGRP and NSE (P<0.01). In the SCLC ED group serum ProGRP and NSE levels[776.33(3 103.4)ng/L, 52.14(60.59)μg/L]were higher than those in the SCLC LD group[295.59(799.65)ng/L, 23.36(22.97)μg/L], respectively (all P<0.001). The serum ProGRP levels of N0, N1, N2 and N3 in TNM staging were 113.0(343.65), 167.04(724.56), 427.42(1 388.62), 735.99(1 709.95)ng/L respectively (all P<0.001). Serum ProGRP and NSE levels were not statistically different between the sex groups and the age groups (all P>0.05). Conclusion: To establish the cut-off value of serum ProGRP is helpful for the diagnosis and differential diagnosis of SCLC.