Objective To analyze the differential diagnostic value of serum CA19-9, mucin 5AC (MUC5AC), and exocytosis Ephrin type A receptor 2 (Exo-EphA2) for pancreatic adenocarcinoma and mass-type pancreatitis, and the correlation with imaging pathological features. Methods A total of 82 patients with pancreatic cancer who were treated in Zhoukou Central Hospital from January 2022 to June 2023 were selected as the observation group, and 41 patients with mass pancreatitis were selected as the control group during the same period. The diagnostic values of the 2 groups and the different pathological parameters of serum CA19-9, MUC5AC, and Exo-EphA2 were compared to analyze their diagnostic values and to analyze the correlation further. Results Serum CA19-9, MUC5AC, and Exo-EphA2 levels were significantly increased in the study group compared with the control group (P<0.05). Comparison of serum CA19-9, MUC5AC, and Exo-EphA2 levels in patients with pancreatic cancer of different pathological parameters. Low differentiation was higher than middle and high differentiation, stage Ⅰ~Ⅱ was lower than Ⅲ~Ⅳ, and distant metastasis was higher than no distant metastasis (P<0.05). The levels of CA19-9, MUC5AC and Exo-EphA2 were positively correlated with distant metastasis and TNM stage, and negatively correlated with the degree of differentiation (P<0.05). The AUC for the combined diagnosis of pancreatic cancer with serum CA19-9, MUC5AC and Exo-EphA2 levels was 0.802, which was higher than that of each index alone. Conclusion There is a relationship between serum CA19-9, MUC5AC, and Exo-EphA2 levels and pathological parameters of pancreatic cancer, and the combined test can significantly enhance the differential diagnostic value in pancreatic cancer and mass-type pancreatic cancer.

Objective To evaluate the impact of valve replacement combined with epicardial left atrial appendage closure with high-risk heart valve disease complicated with atrial fibrillation on short-term outcome. Methods A total of 114 patients who underwent open-heart valve replacement surgery were selected as the research objects. All patients had HAS-BlED score≥3 and CHA2DS2-VASC score≥2 (female≥3). According to whether left atrial appendage was closed, patients were divided into group A (closed group, n=58) and group B (unclosed group, n=56). The operation indexes, cardiac function indexes, blood related factors and the incidence of cardiovascular adverse events after 6 months were observed in the two groups. Result sThe levels of C-reactive protein levels, brain natriuretic peptide, interleukin-1β, interleukin-6 and tumor necrosis factor-α of group A were lower than those of group B (P<0.05). The left atrial diameter and left ventricular end-diastolic diameter of the patients in combined surgery group were decreased (P<0.05), the ejection fraction was increased (P<0.05). The rates of incidence of cardiovascular adverse events occurrence to group B observed six months after operation were higher than those of group A (P<0.05). Conclusion Transepicardial left atrial appendage closure is safe and reliable, and has a good early postoperative effect after operation, which is conducive to the prevention of postoperative stroke.