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Objective:To establish and validate a predictive model for treatment failure of peritoneal dialysis-related peritonitis(PDAP)in elderly patients.Methods:Clinical data of peritoneal dialysis(PD)patients who were followed up from January 1, 2013 to December 31, 2019 at four Grade A tertiary hospitals in Jilin Province were collected.A total of 362 elderly patients with PDAP were eventually included as study subjects.Subjects recruited from 2013 to 2017 were used for model construction and the logistic regression model was used to screen risk factors for treatment failure of PDAP in elderly patients.A nomogarm was constructed to predict treatment failure of secondary PDAP using R language.The receiver operating curve(ROC)and calibration curve were used to evaluate discrimination accuracy of the model.Subjects from 2018 to 2019 were used as the cohort for validation of discrimination accuracy of the model.Results:Of 258 PDAP patients in the modeling cohort, 29 experienced treatment failure, including 15 PDAP-related deaths and 14 cases requiring catheter removal.The multivariate logistic regression model showed that types of pathogens( OR=8.849, 95% CI: 1.656-47.269, P=0.011), long dialysis age( OR=1.023, 95% CI: 1.005-1.042, P=0.013), pre-hospitalization antibiotic treatment( OR=5.123, 95% CI: 1.338-19.610, P=0.017), and dialysate white blood cell count on day 5>100×10 6/L( OR=7.085, 95% CI: 2.162-23.217, P=0.001)were independent risk factors for treatment failure of PDAP in elderly patients.For the nomogarm predictive model, the areas under the ROC curve(AUC)in the modeling cohort and the validation cohort were 0.818(95% CI: 0.735-0.902)and 0.762(95% CI: 0.656-0.889), respectively, and the calibration curves were close to a straight line with a slope of 1. Conclusions:Our nomogram predictive model based on types of pathogens, months of dialysis, pre-hospital admission antibiotic treatment, and dialysate white blood cell count on day 5 has demonstrated satisfactory discrimination accuracy for treatment failure of PDAP in elderly patients.
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Heart sound signal is a kind of physiological signal with nonlinear and nonstationary features. In order to improve the accuracy and efficiency of the phonocardiogram (PCG) classification, a new method was proposed by means of support vector machine (SVM) in which the complete ensemble empirical modal decomposition with adaptive noise (CEEMDAN) permutation entropy was as the eigenvector of heart sound signal. Firstly, the PCG was decomposed by CEEMDAN into a number of intrinsic mode functions (IMFs) from high to low frequency. Secondly, the IMFs were sifted according to the correlation coefficient, energy factor and signal-to-noise ratio. Then the instantaneous frequency was extracted by Hilbert transform, and its permutation entropy was constituted into eigenvector. Finally, the accuracy of the method was verified by using a hundred PCG samples selected from the 2016 PhysioNet/CinC Challenge. The results showed that the accuracy rate of the proposed method could reach up to 87%. In comparison with the traditional EMD and EEMD permutation entropy methods, the accuracy rate was increased by 18%-24%, which demonstrates the efficiency of the proposed method.
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Entropy , Heart Sounds , Signal Processing, Computer-Assisted , Signal-To-Noise Ratio , Support Vector MachineABSTRACT
Objective:To study the expression of ubiquilin2 (UBQLN2) in non-small cell lung cancer (NSCLC) and its effect on the proliferation, invasion and metastasis ability of NSCLC cells.Methods:Immunohistochemistry was used to detect the expression of UBQLN2 in NSCLC cancer (24 cases) and adjacent normal tissues (24 cases), and to analyze the relationship between the expression of UBQLN2 and lymph node metastasis of NSCLC cancer. The expression of UBQLN2 in human normal bronchopulmonary epithelial cells and NSCLC cells was detected by real-time quantitative polymerase chain reaction (qRT-PCR)and Western blot; the effect of UBQLN2 on the proliferation of NSCLC cells was detected by lentivirus overexpression technology combined with MTS and EDU experiments in vitro; the effect of UBQLN2 on the invasion and metastasis of NSCLC cells was detected by scratch experiments in vitro and transwell experiments; a dual-fluorescence autophagy flow detection system was constructed by GFP-LC3-RFP-mLC3 plasmid packaging virus and Western blot was used to detect the change of autophagy after overexpression of UBQLN2; TCGA online data was uesd to analyze the expression level of UBQLN2 and lung cancer patients relevance of prognosis. Results:The expression of UBQLN2 in normal lung tissues was significantly higher than that in NSCLC tissues ( P<0.01), and the expression in patients with negative lymph node metastasis was significantly higher than that in patients with positive lymph node metastasis ( P<0.01); the expression of UBQLN2 in NSCLC cells was significantly lower than that in normal lung epithelial cells, and the overexpression of UBQLN2 could inhibit the proliferation and invasion and metastasis of tumor cells. The expression of UBQLN2 was positively correlated with the prognosis of NSCLC. Conclusions:The expression of UBQLN2 is significantly lower in lung cancer tissues and cells, and is negatively correlated with the lymph node metastasis of NSCLC; UBQLN2 can inhibit the proliferation and invasion of NSCLC cells; the expression of UBQLN2 is positively correlated with the prognosis of patients.
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Objective:To explore the role of small molecule glycoprotein Serglycin (SRGN) in chemotherapy resistance of non-small cell lung cancer (NSCLC).Methods:In NSCLC H1299 cell line, shRNA technology was used to interfere with the expression of SRGN and establish stable interfering cell line. Western blot and real time fluorescence quantitative polymerase chain reaction (qRT-PCR) were used to verify the knockdown efficiency; MTS was used to detect the knockdown cell line′s drug sensitivity to cDDP and Oxaliplatin; enzyme linked immunosorbent assay (ELISA), Western blot and qRT-PCR were used to explore the effect of transforming growth factor β (TGFβ) on SRGN and vice versa; Western blot was used to detect the effect of SRGN on epithelial-mesenchymal transition (EMT) related molecules, and online data bioinformatics was used to analyze the correlation between SRGN and EMT related molecules expression; in addition, online prognostic analysis software (kmplot) was used to analyze the correlation between SRGN, TGFβ and prognosis of lung cancer patients.Results:Comparing with the control group, the test group, knocking down SRGN can obviously improve the drug sensitivity of NSCLC cell to cDDP ( P=0.032 7) or Oxaliplatin ( P=0.014 2). TGFβ can enhance the experission of SRGN in NSCLC and SRGN also can help TGFβ secreted from cells. SRGN promotes the epithelial mesenchyme transition by modulating Snail1. By analyzing TCGA database, we found that the expression of SRGN was negatively correlated with the expression of CDH1 (coding for Ecadherin protein) ( r=-0.25) and there was a positive correlation with Snai1 expression ( r=0.37). These results suggest that SRGN can promote the change of EMT in lung cancer cells through TGF β 1 and snail 1. The overall survival time of NSCLC patients with low expression of SRGN was much longer than the patients with high expression of SRGN ( P=0.007 7). The overall survival time of NSCLC patient with low expression in both SRGN and TGFβ1 or TGFβ2 was 73months or 42.8 months longer than that with high expression in both SRGN and TGFβ1/2. Conclusions:Intercting with TGFβ1, SRGN promotes EMT of NSCLC cells, which facilitates the chemoresistence of NSCLC. The simultaneous low expression of SRGN and TGFβ1 or TGFβ2 can significantly prolong the overall survival of patients with NSCLC.
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Objective: To investigate the feasibility and effectiveness of repairing temporal skin and soft tissue defects and reconstructing sideburns with superficial temporal artery composite perforator flap. Methods: Between January 2018 and January 2019, 12 patients with temporal tumors were treated. There were 5 males and 7 females with an average age of 51 years (range, 37-68 years). There were 8 cases of basal cell carcinoma and 4 cases of squamous cell carcinoma. The disease duration ranged from 3 months to 4 years (mean, 13 months). The area of residual wound after tumor resection was 3.8 cm×2.5 cm-5.2 cm×3.5 cm. The superficial temporal artery composite perforator flap was designed. The hairy superficial temporal artery frontal branch perforator flap was used to repair the hair growing area and reconstruct the sideburn; and the area of the flap was 2.5 cm×1.0 cm-4.2 cm×3.0 cm. And the superficial temporal artery descending branch perforator flap without hair was used to repair the hair-free area; and the area of the flap was 2.5 cm×1.5 cm-7.5 cm×4.0 cm. The donor sites were sutured directly. Results: All flaps survived, and the incisions at the donor and recipient sites healed by first intention. Eleven patients were followed up 6-12 months (mean, 9 months). The incisions were not obvious. The flaps were flat and the color of the flaps were not significantly different from the surrounding skin. The reconstructed sideburns were consistent with the healthy side and the facial appearance was satisfactory. No local tumor recurred during follow-up. Conclusion: For the temporal skin and soft tissue defects involving the sideburn, the superficial temporal artery composite perforator flap can be used to repair subunits with different aesthetic characteristics in sections and has the advantages of operating simply, obtaining satisfied facial appearance, and little effect on the donor site.
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Objective To study the role of leucine rich repeat neuronal 3 (LRRN3) in the prolif-eration of non-small cell lung cancer and its possible mechanism of expression regulation. Methods The expression of LRRN3 in non-small cell lung cancer was detected by real-time quantitative polymerase chain reaction ( qPCR) , immunohistochemistry and bioinformatics retrieval;A lung cancer cell line A549-LRRN3 with stable over-expression of LRRN3 was established by lentivirus over-expression technology;The effect of LRRN3 on the proliferation of non-small cell lung cancer was detected by methyl thiazolyl tetrazolium ( MTT) assay;Bioinformatics search for changes in methylation of LRRN3 promoter region and treatment of lung cancer cells by methyltransferase inhibitors to detect the effect of methylation on the regulation of LR-RN3 expression; Finally, bioinformatics search analyzes the correlation between LRRN3 and lung cancer prognosis. Results The mRNA expression of LRRN3 in clinical tissues of non-small cell lung cancer (n=12) was significantly lower than that of adjacent normal tissues (n=12) (P=0. 0014). The results of immunohistochemistry showed that the protein expression level of LRRN3 in non-small cell lung adenocar-cinoma was lower than that in normal tissues (P=0. 001), and the expression in non-small cell lung squa-mous cell carcinoma was also lower than that in normal tissues (P=0. 003). Overexpression of LRRN3 in-hibited the proliferation of tumor cells (P<0. 01), and the hypermethylation of LRRN3 in the promoter re-gion inhibited its transcriptional expression. LRRN3 was positively correlated with the survival prognosis of lung adenocarcinoma (P=5. 2e-09;HR=0. 48). Conclusions Hypermethylation in the promoter region of LRRN3 inhibits its transcriptional expression, thereby promoting the proliferation of lung cancer cells.
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Objective] To evaluate the acupuncture treatment of type 2 diabetes peripheral neuropathy clinical curative effect and safety. [Methods] Com-puter retrieval of the CENTRAL, Cochrane, Web Of Science, CBM, CNKI, VIP database, find al about acupuncture and moxibustion treatment of type 2 diabetic gastroparesis of randomized control ed trial(RCT), build library retrieval time until March 19, 2014.At the same time ShouJian into literature references.According to inclusion and exclusion criteria, independently by two researchers after RCT extraction and filtering, data quality evaluation, using Revman5.2 Meta analysis software, use the GRADE system for quality evaluation of evidence. [Results] Seven studies involving 364 patients were includ-ed.Meta analysis showed:(1) effective rate:the acupuncture compared with drugs, the results between the two groups were statistical y significant (RR=3.35, 95% CI=(2.05, 5.48)], suggesting that acupuncture treatment can improve efficiency for the treatment of type 2 diabetes peripheral neuropathy. (2) MNCV:the median nerve, and results showed that the statistical significance was found between the two groups[MD=2.29, 95%CI=(0.61, 3.98)].Includ-ing philalways nervous, the result showed that between the two groups had statistical significance[MD=2.16, 95% CI=(0.16, 4.16)].(3)SNCV:includ-ing median nerve, the results showed that the statistical significance was found between the two groups[MD=1.79, 95% CI=(0.57, 3.02)].Including phi-lalways nervous, the result showed that the two groups had statistical significance[MD=3.59, 95%CI=(2.28, 4.91)].Based on GRADE system ,al the evidence was at low level and weak recommendation. [Conclusion] Acupuncture-moxibustion for the type 2 diabetes peripheral neuropathy is better than the conven-tional medicine treatment.Limited by the guality of the inclusive literalures, it needs more high quality, large sample of RCT further argument.
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In genetic engineering antibodies,Fabs antibodies have many advantages,such as lower relative molecular mass, specific tissue distribution and lower immunogenicity, which have made Fabs antibodies the research hotspot for the past few decades. Besides the widely used enzymatic generation, multiple expression systems which include E. coli. and insects are used in the generation of Fabs antibodies. E. coli. expression system is most thoroughly explored and has been used in the preparation of clinical Fabs drugs. There are six Fab drugs that have been approved by FDA, such as certolizumabpegol and many Fabs are still in clinical research. This review discusses the recent research progress of Fabs drugs, including Fabs′ structure and characteristics, the generation and expression of Fabs, strategies to increase production and clinical applications, with the emphasis on generation, expression and clinical applications.
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Resistance to adriamycin was developed in an orignally adriamycin- sensitive strain of Ehrlich ascites carcinoma (EAC) in vivo by treament with the adriamycin during 50 weekly passages of the tumor. The results showed that the growth of the resistant line was slower than that of the EAC, total ascites cell volume,total cell number and mean single-cell volume were significantly smaller of the resistant line than those of original sensitive line. Also, itwas found the homogerously staining region and double minute chromosome in the cells of resistant line. The adriamycin-resistant tumor produced cross resistance to vincristine.mitomycin C,and actinomycin D,while section resistance to VP-16. There was no change in the sensitivity of tumor to oridonin.