Glasgow prognostic score and combined positive score for locally advanced rectal cancer

Purpose@#This study was performed to investigate the association of Glasgow prognostic score (GPS), combined positive score (CPS), and clinicopathological characteristics of locally advanced rectal cancer. @*Methods@#Between February 2012 and February 2018, 103 patients with locally advanced rectal cancer treated by neoadjuvant chemoradiotherapy and total mesorectal excision (TME) were retrospectively evaluated. @*Results@#According to the classification of the GPS, 85 (82.5%), 13 (12.6%), and 5 patients (4.9%) were classified as a score of 0, 1, and 2, respectively. Patients were classified into the GPS-low group (GPS of 0, n = 85) and GPS-high group (GPS of 1 or 2, n = 18) with an area under the curve of 0.582 for overall survival (OS). The mean programmed death-ligand 1 (PD-L1) CPS of the whole group was 2.24 (range, 0–70). The PD-L1 CPS of the GPS-high group was higher than the GPS-low group (P < 0.001). Multivariate analysis by Cox proportional hazards model indicated that GPS was associated with OS and diseasefree survival (DFS). Furthermore, PD-L1 CPS was associated with DFS (hazard ratio, 1.050; 95% confidence interval, 1.017– 1.083; P = 0.003). @*Conclusion@#Elevated GPS was related to the PD-L1 CPS. GPS and PD-L1 CPS were associated with the prognosis of locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy followed by TME.

Prognostic Analysis of NSCLC Based on the Tumor-associated Macrophages, Tumor Neo-vessels and PD-L1 Expression in Tumor Microenvironment / 中国肺癌杂志

BACKGROUND@#Tumor microenvironment is a complex and dynamic community, which plays a crucial role in tumor progression via the co-evolution of cancer cells and tumor stroma. Among them, tumor-associated macrophages (TAMs) and tumor neo-vessels are two key components in the tumor microenvironment during cancer invasion. In addition, programmed cell death ligand 1/programmed cell death ligand 1 (PD-1/PD-L1) also plays an important role in tumorigenesis and development, and the clinical strategies to block PD-1/PD-L1 pathway could have great benefits for cancer patients. This study was aimed at analyzing the quantitative expression and prognostic significance of TAMs, tumor neo-vessels and PD-L1 in tumor microenvironment and exploring the relations between the expression of above components with the patients' prognosis of non-small cell lung cancer (NSCLC).@*METHODS@#Clinico-pathological data and surgical specimens of 92 patients with NSCLC were collected, and immunohistochemistry was used to stain the expression of TAMs, tumor neo-vessels and PD-L1 on tumor tissue and peri-tumor tissues. The inverted microscopy was used to take pictures and Image-pro Plus 6.0 software was used for quantitative analysis. The clinicopathological characteristics and overall survival (OS) were analyzed.@*RESULTS@#The median OS of 92 NSCLC cases was 22.5 month. The expression of TAMs, tumor neo-vessels and PD-L1 in tumor tissue and peri-tumor tissues were not statistically significant (P>0.05). According to the cutoff of above key three components in tumor microenvironment, all the cases could be classified into high, middle and low expression groups. The survival analysis demonstrated that the OS in high expression group of TAMs (P=0.016) and PD-L1 (P=0.002) was shorter than the other two groups, respectively, with statistical significance. The OS in high tumor neo vessels group was shorter than the other two groups. However, there was no statistical significance between these three group (P=0.626). Combined with above the three components, all the cases could be classified into low, middle and high density groups. The survival analysis demonstrated that the median OS of combined high density group was shorter than the other two groups (P=0.001). Multivariate analysis by Cox regression indicated that pathological type, TAMs and PD-L1 expression were the independent prognostic factors.@*CONCLUSIONS@#The key components of TAMs and PD-L1 in tumor microenvironment are closely related to the prognosis of NSCLC patients.

The prognostic analysis of hepatocellular carcinoma based on the tumor neo-vessels, macrophages and α-SMA in tumor microenvironment / 中华肿瘤杂志

Objective@#To analyze the quantitative expression and prognostic significance of tumor neo-vessels, macrophages and fibroblasts in tumor microenvironment of hepatocellular carcinoma (HCC).@*Methods@#The clinic-pathological features and tissue samples for 101 HCC cases were collected. Immunohistochemistry was used to stain the tumor neo-vessels, macrophages and fibroblasts on tumor tissue. The distribution results and quantitative data of above key components were acquired by inverted microscopy equipped with CRi Nuance multispectral analysis system. The number of tumor neo-vessels and macrophages on HCC tissue were counted and the thickness of cancer stroma based on the expression of fibroblasts was measured. The clinic-pathological characteristics and overall survival were analyzed.@*Results@#The median disease free survival (DFS) of 101 HCC cases was 5 month. The quantitative analysis of tumor neo-vessels, macrophages and fibroblasts showed that the expression range was 51-429 with median 218, 110-555 with median 259, 35.61-555.35 with median 246.98, respectively. To take the median as cutoff, all the cases could be classified into high and low expression group. The survival analysis demonstrated that the high density group of macrophages (P=0.022) and fibroblasts (P<0.001) has shorter DFS than low density group, with statistical significance. The high tumor neo-vessels group has shorter DFS with median 5 month than low density group with median 7 month. However, there was no statistical significance between these two group (P=0.197). Combined with above the three stromal components, all the cases could be classified into low, middle and high group. The survival analysis demonstrated that the high density group of stromal components has shorter DFS than the other two groups with median 3 month (P=0.001). Multivariate analysis by Cox regression indicated that cirrhosis, metastasis status, macrophages and fibroblasts density were the independent prognostic factors.@*Conclusion@#The key elements in tumor microenvironment including tumor neo-vessels, macrophages and fibroblasts were heterogenic in HCC tissues and played significant roles in HCC invasion and metastasis.

Expression of DAB2IP and β-catenin in bladder urothelial carcinoma and their clinical significance / 临床与实验病理学杂志

Purpose To investigate the clinical utility of DAB2IP (DOC-2/DAB2 interactive protein)and β-catenin expression in bladder urothelial carcinoma (BUC).Methods The expression of DAB2IP and β-catenin was detected in 104 BUC cases and 40 peritumorial tissues using EnVision two-step immunohistochemical method,and the association with BUC clinicopathological parameters was analyzed.Results The expression of DAB2IP in BUC was significantly less than that of peritumorial normal tissues,and the expression of β-catenin in BUS was significantly higher than that of peritumorial normal tissues (P ＜ 0.05).DAB2IP expression and histologic grading,clinical pathologic staging and 5 years survival rate had statistical significance (P ＜ 0.05).No statistical significance with gender,age,tumor diameter and in patients with incipient/recurrence.β-catenin expression and age,histologic grading,clinical pathologic staging,tumor diameter and 5 years survival rate have statistical significance (P ＜ 0.05).No statistical significance correlated with gender and in patients with incipient/ recurrence,DAB2IP and β-catenin expression in BUC are negatively correlated (P ＜ 0.05).Conclusion In bladder urothelial carcinoma,down-regulation of DAB2IP and up-regulation of β-catenin,are in a negative correlation.Abnormal expression of DAB2IP and β-catenin is correlated with histologic grading,clinical pathologic staging and prognosis.

Analysis of Clostridium difficile associated diarrhea in pediatric patients with antibiotic-associated diarrhea / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the incidence and treatment of Clostridium difficile infection (CDI) in pediatric patients with antibiotic-associated diarrhea (AAD).</p><p><b>METHOD</b>Clinical data of totally 577 pediatric patients with AAD seen from January 2012 to January 2014 were collected; those children were divided according to age into 4 groups, 0.25 -1 year, >1 -4 years, >4 -12 years and >12 -18 years old groups, and 220 healthy children were enrolled as controls. CDI was tested by C. Diff Quik Chek Complete (QCC) and BD GeneOhm™ C. Diff Assay (BD-PCR) in all children, and the CDI incidence of four groups was added up. All pediatric patients with AAD were divided into mild, general and severe type according to different symptoms of diarrhea, and grading treatment, the general type and severe type of CDI children were treated with metronidazole and (or) vancomycin, afterwards, the results of grading treatment were analyzed.</p><p><b>RESULT</b>The number of pediatric patients with AAD were 178, 177, 132 and 90 in 0. 25 - 1 year, > 1 -4 years, > 4 - 12 years and > 12 - 18 years old group, respectively. The positive rate of CDI (22. 0% (39/177)) in > 1 -4 years old AAD patients was very significantly higher compared to the controls (4% (4/91), P < 0. 001), the rate of CDI (21. 2% (28/132)) in > 4 - 12 years old AAD pediatric patients was significantly higher compared to the controls (4% (2/53), P = 0. 004), the rates of CDI in 0. 25 - 1 year and > 12 - 18years old AAD groups were not significantly different from that of the controls (P >0. 05). There were 285 mild type AAD children (no CDI children), 176 general type AAD children (including 47 CDI children), and 116 severe type AAD children (including 81 CDI children). After grading and symptomatic treatment, there were 16 recurrent diarrhea in 128 CDI patients (severe type AAD), and the rest recovered. Two cases were transferred for referral treatment, 2 cases died, and the rest 12 recurrent diarrhea children fully recovered after administration of metronidazole, vancomycin, probiotics and symptomatic treatment.</p><p><b>CONCLUSION</b>The > 1 -12 years old AAD children had higher CDI rate than healthy children; administration of metronidazole and (or) vancomycin was effective for CD infection.</p>

Analysis of Clostridium difficile Infection Secondary to Triple Therapy in Pediatric Patients with Helicobacter pylori Infection / 胃肠病学

(P > 0. 05). Conclusions:Metronidazole-containing triple therapy may reduce the CD infection secondary to eradication of Hp infection in pediatric patients,and has no negative impact on efficacy of Hp eradication.

Incidence and risk factor analysis of antibiotic-associated diarrhea of pediatric patients with severe bacterial pneumo-nia / 临床儿科杂志

ObjectiveTo investigate the incidence and risk factors of antibiotic-associated diarrhea (AAD) of pediatric patients with severe bacterial pneumonia.MethodsClinical data of 1086 pediatric patients with severe bacterial pneumonia from January 2010 through January 2014 were recruited. The incidence and risk factors of AAD were retrospectively analyzed. ResultsThe incidence of AAD in 1086 pediatric patients with severe bacterial pneumonia was 36.74%. The incidence of AAD in patients younger than 2 years old were higher than that in those older than 2 years, once or more times of mechanical venti-lation history were higher than that with no arrangements of this treatment, administering of combined antibiotics therapy were higher than that with single antibiotics, and the incidence of AAD due to amoxicillin/clavulanate, piperacillin/tazobactam, cefo- perazone/sulbactam in pediatric patients were 43.55%, 43.75%, and 45.03%, respectively. Three β-lactam/β-lactamase inhibitors above were risk factors of AAD through multivariate Logistic regression analysis.ConclusionThe high incidence of AAD in pediatric patients with severe bacterial pneumonia was associated with some risk factors, including younger than 2 years old, me-chanical ventilation, combined antibiotics therapy and administration of β-lactam/β-lactamase inhibitor (amoxicillin/clavulanate, piperacillin/tazobactam, cefoperazone/sulbactam).

The pathogens analysis of pneumonia children with antibiotic-associated diarrhea / 中国医师进修杂志

Objective To investigate the intestinal pathogens in pneumonia children with antibioticassociated diarrhea (AAD).Methods The etiological data of 208 pneumonia children with AAD were analyzed retrospectively.Results The results dictated there were 46 A and/or B toxin-positive samples of Clostridium difficile(CD),and after culturing there were 122 Candida,107 Escherichia coli,42 Staphyloccocus aureus,28 Clostridiurn perfringens,21 Klebsiella oxytoca,18 Enterobacter cloacae,12 Klebsiella pneumoniae,8 Pseudomonas aeruginosa in the fecal specimens of 208 pneumonia children with AAD.Conclusions The pathogens are complicated in pneumonia children with AAD,the highest detection rate are Candida and Escherichia coli.The antibiotic use time of treatment of CD infection AAD and the hospital stay time are the longest,AAD treatment should be made according to different pathogens situation.

Serous microcystic adenoma of pancreas: a clinicopathological study / 中华肝胆外科杂志

Objective To study the clinicopathological features in the diagnosis of serous microcystic adenoma of pancreas.Method A clinicopathological and immunohistochemical study was conducted on 7 patients with serous microcystic adenoma of pancreas.Results All the patients were female,with a mean age of 51 years.Clinical symptoms were present in 2(28.6％)patients.On microscopy,the tumor composed of variable-sized cysts.The cyst wall was covered by simple cuboidal epithelium.The cytoplasm was clear and glycogen-rich.The nucleus of the epithelial cells was small and round.In the center,there was no nucleolus and no nuclear division.There were bulky fibrous tissues between the cystic cavities.Immunohistochemical study showed AE1/AE3,CK7,CK8,CK19,CK/LMW,EMA were positive,and CEA,CD31,CD34,D2-40,Syn,CgA,Calretinin,Vim were negative.Conclusions Serous microcystic adenoma of pancreas is a rare tumor,which was common in old women.Serous microcystic adenoma of pancreas is a benign tumor with good prognosis.The diagnosis is made on histopathological and immunohistochemical study.

Determination of the Content of Lomefloxacin in Hollow Type Suppository by RP-HPLC / 中国药房

OBJECTIVE:To establish the method for determining the content of Lomefloxacin in hollow type suppository of Lomefloxacin hydrochloride.METHODS:RP-HPLC was used with Eclipse XDB-C 18 column(4.6mm?250mm)and the mobile phase consisting of citric acid(0.05mol/L)-acetonitrile(82∶18)the pH of which was adjusted to4.0with triethy?lamine.The flow rate was1.0ml/min and the detection wavelength was287nm.RESULTS:The average recovery of Lome?floxacin was99.8%and RSD was0.6%.CONCLUSION:The method is rapid and accurate and can be used for determination of the content of Lomefloxacin in hollow type suppository.

Study on the Bacterial Endotoxin Test for Lomefloxacin Hydrochloride and Glucose Injection / 中国药房

OBJECTIVE:To study the bacterial endotoxin test for lomefloxacin hydrochloride and glucose injection.METHODS:According to the assigned method and guiding principle for bacterial endotoxin test in CHINESE PHARMACOPOEIA 2000,the interference test was performed.RESULTS:Lomefloxacin and glucose injection could interfere with limulus test,however,the interference could be eliminated after adjusting the pH of injection to 6.8～7.0.The proper concentration of limulus test agent of bacterial endotoxin test was 0.25EU/ml.CONCLUSION:Bacterial endotoxin test can be used for quality control of lomefloxacin and glucose injection.