ABSTRACT
Objective:To investigate the value of plasma Epstein-Barr virus (EBV) DNA detection in the screening of nasopharyngeal carcinoma (NPC) and its clinical application in non-high-risk areas.Methods:Plasma EBV DNA results in 1 153 newly diagnosed nasopharyngeal carcinoma patients who were treated in Sichuan Cancer Hospital from 2015 to 2020 and 244 healthy control cases with matched sex and age were retrospectively analyzed. EBV DNA were detected by quantitative real-time PCR. Positive rate of EBV DNA was determined by the cutoff value of 400 (≥400 copies/ml as positive) and optimization threshold method (presence of S amplification curve as positive). Further analyses were conducted to compare EBV DNA load in different clinical stage, TNM stage and regions distribution characteristics. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of the cutoff value of 400 and optimization threshold method for NPC.Results:Compared with healthy controls, EBV DNA increased significantly in newly diagnosed NPC patients ( P<0.001). Both evaluation methods revealed that the EBV DNA positive percentage increased with TNM and clinical stage ( P<0.001). With 400 copies/ml as cutoff value, the diagnostic sensitivity and specificity were 40.85% and 100%, respectively. The area under the curve was 0.704 (95% CI 0.676-0.733, P<0.001). Evaluated by the optimization threshold method, the sensitivity and specificity could improve to 82.0% and 99.2%, respectively, and the area under the curve reached 0.910 (95% CI 0.894-0.924, P<0.001). Conclusions:In the low prevalence area of nasopharyngeal carcinoma, the sensitivity for diagnosis of nasopharyngeal carcinoma is only 40.9% by the 400 copies/ml cutoff value method. The optimization threshold method is a better choice to improve the diagnostic sensitivity without lowering the diagnostic specificity.
ABSTRACT
Objective To evaluate the curative effect of coenzyme complex and potassium magnesium aspartate on the restoration of rhythm and anti-arrhythmia in postoperative valve replacement patients for rheumatic heart disease.Methods Eight two patients with rheumatic heart disease were randomized into 2 groups,with no statistical significance in the patients' parameters.Treatment group A (n =41 )received i.v.coenzyme complex and potassium magnesium aspartate 30 ml during operation.Group B ( n =41 ) were only given potassium magnesium aspartate 30 ml.Other conventional therapies were the same for the two groups.At the same time,rate of spontaneous restoration of rhythm and severe arrhythmia incidences and low cardiac output syndrome were also recorded.Results The rate of spontaneous restoration of rhythm in the treatment group were higher than that in the control group ( 97.56％ vs 80.49％,x2 =6.12,P =0.01 ).There were significant differences in the severe ventricular tachycardia,ventricle fibrillation and auricular flutter events between the 2 groups ( 19.51％ vs 41.46％,x2 =4.67,P =0.03 ).The rate of low cardiac output in the treatment group were lower than that in the control group( 14.63％ vs 36.58％.x2 =5.18,P =0.02).To evaluate the effect of combination therapy on the spontaneous restoration of rhythm,Logistic regression analysis showed that OR( odds ratio) value was 9.69 and 95％ CI( confidence interval) was 1.15 - 81.55 ( P =0.03 ).Other variables affecting the spontaneous restoration of rhythm included the time of aortic obstruction( OR =9.28,95％ CI 1.21 - 78.18,P =0.02) and cardiac function before operation ( OR =4.95,95％ CI 1.27 - 17.88,P =0.02),operating time (OR=3.99,95％CI 1.18- 11.62,P =0.04),age(OR=2.77,95％CI1.11 -9.74,P=0.04).Conclusion Combined administration of coenzyme complex and potassium and magnesium aspartate in the operation of valve replacement in patients with rheumatic heart disease is able to promote the spontaneous heart rhythm restoration and reduce the chance of severe ventricular tachycardia and low cardiac output events.