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Objective:To investigate the changes of serum Golgi protein 73 (GP73) expression and its clinical significance in breast cancer patients before and after radiotherapy.Methods:A total of 135 patients with primary breast cancer who were diagnosed and treated in Qingdao Hospital Affiliated to Shandong First Medical University Hospital from Aug. 2016 to Dec. 2017 were selected and received standard radiotherapy after surgery. Enzyme-linked immunosorbent assay (ELISA) was used to determine the content of GP73 in the serum of patients before and after radiotherapy, and the differences in the expression levels of GP73 before and after radiotherapy in patients with different molecular phenotypes, tumor stages, and pathological types were compared. Association between the expression of serum GP73 and clinical outcome before and after radiotherapy was analyzed.Results:The expression of GP73 in breast cancer patients was (117.69±33.57) mg/L before radiotherapy and (101.88±30.92) mg/L after radiotherapy, and the difference was statistically significant ( t=4.025, P<0.001) . Different molecular phenotypes were stratified and found that the expression of serum GP73 in patients with luminal A, luminal B, HER-2 overexpression, and triple negative after radiotherapy decreased compared with those before radiotherapy, but only the HER-2 overexpression type had statistically significant difference between before and after radiotherapy ( P<0.05) . Stratification according to different tumor stages showed that the expression of serum GP73 in patients with stage I, II, III and IV after radiotherapy was lower than that before radiotherapy, but only the patients with stage II, stage III, and stage IV were compared before and after radiotherapy, and the difference was statistically significant ( P<0.05) . Stratification according to different pathological types showed that the expression of serum GP73 in patients with invasive ductal carcinoma before and after radiotherapy was significantly lower in patients with invasive lobular carcinoma ( P<0.05) . In addition, the 1-year survival rate of the descending group was significantly higher than that of the ascending group, while the local recurrence rate and the occurrence of distant metastasis were significantly lower than those of the ascending group, and the difference was statistically significant ( P<0.05) . Conclusions:The expression level of serum GP73 in breast cancer patients after radiotherapy is significantly higher than that before radiotherapy, and it has a certain relationship with molecular phenotype, tumor stage, and pathological type. At the same time, the increase in serum GP73 expression after radiotherapy may be detrimental to the clinical outcome of patients.
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Objective:To study the non-target metabolomics analysis and to analyze the metabolomic changesof cerebrospinal fluid (CSF) in patients with tuberculous meningitis.Methods:Case-control study. From July 2018 to July 2019, 20 cerebrospinal fluid specimens of diagnosed patients with tuberculous meningitis were collectedin the department of neurology from the first medical center of the PLA general hospital and the eighth medical center of the PLA general hospital and 20 CSF without tuberculous meningitis as the control. Among them, there were 12 males and 8 femalesin the tuberculous meningitis group, aged (37.9±16.1) years; there were 13 males and 7 femalesin the control group, aged (34.7±14.8) years. Using ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS) technology with three different mode, namely reverse phase chromatography positive ion mode, reverse phase chromatography negative ion mode and hydrophilic chromatography positive ion mode,to detectthe metabolic fingerprints of patients′CSF and analyzed by SIMCA software for orthogonal partial least squares discriminant analysis (OPLS-DA). The variable importance projection value of OPLS-DA model (threshold value>1) plus the P value of t-test (P<0.05) was applied to find the differential metabolites in the cerebrospinal fluid of the two groups of patients.Results:Ten differential metabolites were found in CSF, including L-isoleucine, L-phenylalanine, L-kynurenine, L-methionine, L-tyrosine acid, dimethylglycine, L-alanine, L-threonine, L-histidine and L-lysine, and all of them were up-regulated in the tuberculous meningitis group.Conclusion:Changesof the amino acid metabolism found in the cerebrospinal fluid of tuberculous meningitis patients can provide basis for differential diagnosis and basic molecular research of tuberculous meningitis.
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Objective To investigate the clinical characteristics of DCD donor-derived CRKP infection and bleeding in kidney transplantation,and to summarize the experience of diagnosis,treatment and prevention.Methods A retrospective analysis was carried out from July 2016 to December 2017 in hospital,containing clinical data of 4 cases of CRKP-infected DCD donors and 7 cases of kidney transplantation recipients.Results In the CRKP culture of 4 cases of DCD donors,1 case was positive for blood culture,1 case was positive for urine culture,1 case was positive for sputum culture,and 1 case was negative for blood,urine and sputum culture.The corresponding 7 recipients were all positive for blood culture after renal transplantation,4 cases were positive for urine culture,3 cases were positive for sputum culture,and 5 cases were positive for perirenal drainage.Of the 7 patients,4 cases had renal artery hemorrhage,1 of them was died.The average bleeding time was 17.75 days after operation (14-19 days).In 7 patients with renal transplantation,CRP increasd.And in 3 cases of deaths,CRP was stably higher than normal.Meanwhile,CRP in 4 surviving patients gradually decreased to the normal range after effective anti-infection treatment.All 7 patients were treated with carbapenems;2 patients were dead without avibactam therapy;and 5 cases were treated with avibactam and carbapenems and survived,1 case died and 1 case had good renal function recovery.Conclusion Positive CRKP in blood,urine and sputum of DCD donors can lead to CRKP infection in kidney transplant recipients.Even if the body fluids of donors are all negative,the false negative results could not be excluded.Persistent or increased high-level CRP after operation is an early warning on CRKP infection.And CRP can be used as an indicator for evaluating the effectiveness of anti CRKP therapy.The combination of avibactam and carbapenem antibiotics is an effective regimen in the treatment of DCD donor-derived CRKP.