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Objective:To detect the mRNA expression and methylation status of leucine rich repeat containing 55(LRRC55) gene in pancreatic carcinoma tissues, and discuss the clinical value.Methods:Resected pancreatic ductal adenocarcinoma and normal adjacent specimens from 37 patients admitted in General Surgery of First Affiliated Hospital of Naval Medical University were collected from May 2019 to May 2021. Another two normal pancreas specimens and two blood samples from healthy adults were also collected. All patients′ age, gender, tumor location, tumor size, tumor differentiation, TNM staging, lymphatic metastasis, CEA and CA19-9 level were recorded. Bisulfite treatment of genomic DNA and sequencing analysis was used to study methylation patterns in CpG islands of the promoter for LRRC55 gene in fresh tissues from 2 pancreatic adenocarcinoma and adjacent tissues, 2 normal pancreatic tissues, 2 pancreatic cancer cell lines (PaTu8988 and ASPC1). LRRC55 mRNA in 35 pancreatic adenocarcinoma and adjacent tissues was detected by real-time quantitative PCR and the correlations with clinical parameters were analyzed.Results:CpG islands of LRRC55 in pancreatic adenocarcinoma tissues and pancreatic cancer cell lines was highly methylated and the mean methylation rate was 53% and 71%, respectively; while LRRC55 gene in pancreatic adjacent tissues and normal pancreatic tissues was lowly methylated, and the mean methylation rate was 8% and 11%. The relative expression in the pancreatic adenocarcinoma tissues and the paired adjacent normal tissues was 0.21 (0.02, 1.00 ) and 0.98 (0.33, 3.66 ), respectively; the former was significantly lower than the later and the difference was statistically significant ( P=0.003). Correlation analysis showed that LRRC55 mRNA expression level was related to tumor differentiation and CEA, but not correlated with patients′ age, gender, tumor location and size, CA19-9 level, lymphatic metastasis and TNM staging. Conclusions:Pancreatic cancer tissue and cell lines had abnormal methylation of LRRC55 gene; LRRC55 gene hypermethylation was related with its lower mRNA expression level in pancreatic cancer, which was correlated with the tumor differentiation and CEA level. LRRC55 may be a potential suppressor gene for pancreatic cancer.
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Objective:To investigate the relationship between serum lipid levels and the risk of pulmonary embolism in patients with non-valvular atrial fibrillation.Methods:Patients with non-valvular atrial fibrillation admitted to Tianjin Chest Hospital from January 2014 to January 2019 were retrospectively analyzed.According to whether pulmonary embolism was present on CT pulmonary angiography, patients were divided into two groups, the atrial fibrillation with pulmonary embolism group(the AP group)and the control group(the AF group). Clinical data and serum lipid test results were compared between the two groups.The relationship between serum lipid levels and the risk of pulmonary embolism was evaluated.Results:Levels of apolipoprotein A1(ApoA1)and high-density lipoprotein cholesterol(HDL-C)in the AP group were(1.09±0.25)g/L and(1.03±0.28)mmol/L, which were lower than those in the AF group(1.24±0.25)g/L and(1.21±0.37)mmol/L)( t=3.255, P=0.002; t=2.972, P=0.004, respectively). Levels of very low-density lipoprotein cholesterol(VLDL-C)in the AP group were(0.41±0.24)mmol/L, which were higher than those in the AF group(0.26±0.18)mmol/L)( t=-3.761, P=0.000). The grade of cardiac function on admission in the AP group was higher than that in the AF group( χ2=13.074, P=0.004). The proportion of patients treated for atrial fibrillation in the AP group was lower than that in the AF group( χ2=5.445, P=0.020). Logistic regression analysis showed that decreased ApoA1 and left cardiac insufficiency were risk factors for pulmonary embolism in patients with non-valvular atrial fibrillation( OR=8.793, 95% CI: 1.815~42.607, P=0.007; OR=4.388, 95% CI: 1.352~14.244, P=0.014, respectively). Decreased VLDL-C and atrial fibrillation therapy were protective factors for pulmonary embolism( OR=0.180, 95% CI: 0.053~0.610, P=0.006; OR=0.268, 95% CI: 0.072~0.992, P=0.049, respectively). Conclusions:Pulmonary embolism in patients with non-valvular atrial fibrillation is related to serum lipid levels.Regulating levels of serum lipids may reduce the risk of pulmonary embolism in patients with non-valvular atrial fibrillation.
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Objective To evaluate the value of medical treatment in the management of SAP.Methods From January 2000 to December 2011,a total of 1064 cases out of 931 SAP patients were admitted and retrospectively analyzed.The etiologies,severity score,complication rates,therapies,effectiveness and costs of those SAP cases were summarized.Results There were 559 males and 372 females with a mean age of (51 ± 15)years old.The main cause was biliary tract disease (58.3％),followed by fat-rich diet (31.2％),hyperlipidemia (13.6％) and alcohol (7.1％).At the time of admission,95.5％ of SAP patients presented with level D disease according to Balthazar CT severity index,26.0％ had a Ranson score ≥3 and 30.1％ had an APACHE Ⅱ score ≥ 8.There were 42.7％ cases complicated with systemic inflammatory response syndrome (SIRS).Acute lung injury and acute respiratory distress syndrome (ARDS),acute kidney injury,shock or heart failure,acute liver dysfunction,and diffuse intravascular clotting (DIC)occurred in 24.0％,8.1％,5.4％,3.2％,and 1％ of all patients,respectively.Other complications of SAP included abdominal cavity bleeding (n =17),pseudocyst bleeding (n =9),pancreatic abscess (n =78) and gastrointestinal fistula (n =33).Totally 25 (2.3％) patients died in hospital and 36 (3.4％) patients were discharged against advice,with an overall treatment success rate of 94.3％.The mean hospital stay was (23.7 ± 19.2) d,and the average cost was 52.3 thousands of RMB.Conclusions A comprehensive treatment pathway relying on medical treatment,focusing on organ function support and assisted by miniinvasive intervention may improve the treatment success rate of SAP,which is worth of further application.