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Objective:To compare the survival outcomes in patients of small cell lung cancer (SCLC) with brain-single metastasis and brain with organs-multiple metastasis.Methods:Using the US surveillance, epidemiology and final results database, 5 520 SCLC patients with complete clinical information from 2004 to 2015 were selected. SCLC patients were adjusted, stratified or matched according to the metastasis site after the stratification or matching of the propensity scores, and the lung cancer-specific survival (CSS) rate and overall survival (OS) rate were compared between brain-single metastasis group and brain with organs-multiple metastasis group. In addition, the effects of chemotherapy and radiotherapy in CSS between brain-single metastasis group and brain with organs-multiple metastasis group were compared.Results:Of the 5 520 SCLC patients, 2 658 cases was in the brain-single metastasis group, and 2 862 cases was in brain with organs-multiple metastasis group. After the stratification or matching of the propensity scores, the median survival time in brain-single metastasis group was significantly longer than that in brain with organs-multiple metastasis group (6 months vs. 4 months), and there was statistical difference ( P<0.05). The fatality rate in brain-single metastasis group was significantly lower than that in brain with organs-multiple metastasis group (80.66% vs. 85.96%), and there was statistical difference ( P<0.01). Kaplan-Meier survival curve analysis result showed that the OS rate and CSS rate in brain-single metastasis group were significantly higher than those in brain with organs-multiple metastasis group (14.72% vs. 9.50% and 19.34% vs. 14.04%), and there were statistical differences ( P<0.05). Cox analysis result showed that age, race, T stage, gender, N stage, radiotherapy, chemotherapy, tumor diameter, marriage and metastasis were the influencing factors of CSS rate in SCLC patients with brain metastasis ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that radiotherapy and chemotherapy can significantly improve the CSS rate ( HR = 0.668 and 0.671, 95% CI 0.570 to 0.783 and 0.573 to 0.786, P < 0.01). Conclusions:The survival rate in SCLC patients with brain-single metastasis is higher than that of SCLC patients with brain with organs-multiple metastasis; chemotherapy and radiotherapy can improve the survival rate in SCLC patients with brain metastasis.
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Objective@#Previous cross-sectional studies suggested that elevated levels of total cholesterol content of erythrocyte membrane (CEM) could significantly increase the risk of acute coronary syndrome (ACS). The purpose of the present study was to assess the predictive value of baseline CEM levels for the risk of clinical endpoint events in patients with ACS through prospective follow-up studies.@*Methods@#This study is a prospective follow-up study, which consisted of 859 patients with first ACS (698 patients with unstable angina pectoris and 161 patients with acute myocardial infarction), diagnosed and hospitalized in the First and Second Affiliated Hospital of Anhui Medical University. The routine blood lipid levels and CEM were measured. Patients were divided into two groups according to the median of baseline CEM: CEM≤131.56 μg/mg group (n=430) and CEM>131.56 μg/mg group (n=429). Patients were followed up at 6 months interval. The clinical endpoints were nonfatal myocardial infarction, nonfatal stroke, all-cause mortality, all-cause mortality, heart failure requiring hospitalization, and coronary artery revascularization. Kaplan-Meier curve analysis and Cox proportional hazard model were used to analyze the impact of elevated CEM on the occurrence of clinical end-point events. HR values and 95%CI of each variable were obtained. Cox regression analysis of all-cause mortality was performed according to whether patients had risk factors for coronary heart disease (hypertension, diabetes, smoking and elevated LDL-C) and whether they were treated with PCI.@*Results@#The follow-up time was 1 640 (1 380, 2 189) days. Cox analysis after adjustment showed that an elevated baseline of CEM (>131.56 μg/mg) was associated with an increased risk of all-cause mortality (HR=1.690, 95%CI 1.041-2.742, P=0.034), but had no significant predictive effect on the other clinical endpoints. Subgroup analysis showed that elevated baseline CEM levels in ACS patients with LDL-C>1.8 mmol/L (HR=1.687, 95%CI 1.026-2.774, P=0.039), receiving in-hospital PCI (HR=2.365, 95%CI 1.054-5.307, P=0.037), or male (HR=1.794, 95%CI 1.010-3.186, P=0.046) were associated with an increased risk of all-cause mortality.@*Conclusion@#The results showed that elevated CEM levels can increase the risk of all-cause mortality in ACS patients.
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Objective To analyze the relationship between serum levels of interleukin (IL)-33 , IL-18 and the level of immunoglobulin-E (IgE), eosinophils (EOS) in patients with acute asthma attack. Methods Eighty patients of acute asthma attack (observation group) and 80 cases of healthy physical examination (control group) were selected. The levels of IL-33 and IL-18 were determined by enzyme-linked immunosorbent assay (ELISA) method and compared between two groups. The levels of EOS and IgE were measured by automatic analyzer , and the relationship between serum levels of interleukin (IL)-33 and IL-18 and the level of immunoglobulin-E (IgE) and eosinophils (EOS) was analyzed in patients with acute asthma attack. Results The levels of IL-18 and IL-33 in observation group were (310.2 ± 152.6), (215.4 ± 87.5) ng/L, in control group were(204.2 ± 95.4), (138.7 ±48.3) ng/L, and there were significant differences (P < 0.05). The levels of IL-18 and IL-33 in observation group after treatment were (215.5 ± 98.2), (146.6 ± 54.9) ng/L, significantly lower than those before treatment (P<0.05). The levels of EOS and IgE had positive relation with the level of IgE and EOS (P < 0.05). Conclusions The levels of IL-18 and IL-33 in patients with acute asthma attack increase, and both of them significantly decrease after treatment. They are positively correlated with IgE and EOS.
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Objective To analyze the relationship between serum levels of interleukin (IL)-33 , IL-18 and the level of immunoglobulin-E (IgE), eosinophils (EOS) in patients with acute asthma attack. Methods Eighty patients of acute asthma attack (observation group) and 80 cases of healthy physical examination (control group) were selected. The levels of IL-33 and IL-18 were determined by enzyme-linked immunosorbent assay (ELISA) method and compared between two groups. The levels of EOS and IgE were measured by automatic analyzer , and the relationship between serum levels of interleukin (IL)-33 and IL-18 and the level of immunoglobulin-E (IgE) and eosinophils (EOS) was analyzed in patients with acute asthma attack. Results The levels of IL-18 and IL-33 in observation group were (310.2 ± 152.6), (215.4 ± 87.5) ng/L, in control group were(204.2 ± 95.4), (138.7 ±48.3) ng/L, and there were significant differences (P < 0.05). The levels of IL-18 and IL-33 in observation group after treatment were (215.5 ± 98.2), (146.6 ± 54.9) ng/L, significantly lower than those before treatment (P<0.05). The levels of EOS and IgE had positive relation with the level of IgE and EOS (P < 0.05). Conclusions The levels of IL-18 and IL-33 in patients with acute asthma attack increase, and both of them significantly decrease after treatment. They are positively correlated with IgE and EOS.
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Objective To determine the sensitivity of autofluorescence bronchoscopy (AFB) in the assessment of tumor size and therapeutic strategy.Methods Patients with imaging suspected of malignancy were examined with both white light bronchoscopy (WLB) and AFB.The area of tumor infiltration,imaging information and pathological results were analyzed.Results A total of 212 patients were enrolled,including 180 male and 32 female.In 24 patients (13.2％),greater tumor volume was revealed by AFB than by WLB alone.In these patients,the median diameter of tumor was ＞ 1 cm wider on AFB examination than on WLB.Therapeutic strategy was changed in 18 patients (9.9％) after receiving AFB,including 15 patients with expanded scope of removal and 3 patients with avoidance of surgery.In the univariate analysis,the pathological type of squamous cell carcinoma and tumor invasion in two or more segments of bronchus were independent predictive factors.Diagnostic sensitivity of AFB group was 85.7％,specificity 73.3％,positive predictive value 95.1％,false predictive value 45.8％.Diagnostic sensitivity of WLB group was 72.5％,specificity 60.0％,positive predictive value 91.7％,false predictive value 26.5％.Conclusion Our study suggests that compared with WLB alone,autofluorescence bronchoscopy plus WLB significantly improves the diagnostic value and treatment outcome of central lung cancer.
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Objective To investigate the changes of fractional exhaled nitric oxide (FENO)) and their relation with lung function in bronchial asthma.Methods FENO and forced expiratory volume in the first second (FEV1) were measured during the periods of acute onset,chronic persistence and paracmasis in 54 patients with asthma and 19 healthy persons.Results There were significant differences in the levels of FENO and FEV1 among the course of acute onset [(57.59 ± 32.24) ppb and (1.72± 0.33) L],chronic persistent course [(40.02 ± 15.68) ppb and (2.41 ± 0.23) L],paracmasis [(26.71±6.07) ppb and (2.82±0.29 )L]and control[(14.74±3.42 ) ppb and (2.93±0.13)L] (F=19.555,163.096,P＜0.01) except for the levels of FEV1 between paracmasis and control group(P＞0.05).The negative correlation between FENO and FEV1 was found in the course of acute onset(r=- 0.666,P =0.005 ),but not in the chronic persistent course ( r =- 0.288,P =0.176) and paracmasis(r=-0.246,P=0.457).Conclusions The level of FENO is increased and may be useful to evaluate control degree in patients with asthma.
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The clinical data of 22 cases with gastrointestinal stromal tumors were retrospectively analized.The main clinical manifestations were gastrointestinal bleeding (14/22),abdominal discomfort (5/22) and abdominal lump (3/22),stomach was the most common site of the tumor (14/22).All 22 cases underwent surgical treatment and pathological examination confirmed that 12 cases were benign.Immunohistochemical results showed that 68% cases were negative in solubility acid protein-100 (S-100),and the positive rates of tyrosine-protein kinase acceptor 117 (CD117),hemopoietic stem cell antigen 34 (CD34) and negative rate of smooth muscle actin (SMA) were all 73%.Eighteen cases were followed up for 1-5 years after operation,among them 3 died.The survival was closely related to the size,the pathological characteristics and the recurrance of the tumor as demonstrated by multivariate Cox regression analysis.Since gastrointestinal stromal tumor has no specific clinical manifestations,preoperative diagnosis is difficulty,so surgical resection and subsequent pathological examination is used for confirmation of diagnosis,as well as treatment of the disease.
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Bone marrow mesenchymal stem cells (BMSCs) possess the potential of self-duplication, multi-directional differentiation, and also the ability to differentiate (in the direction of ectoderm) into neuron and neuroglial cells in vitro as well as to promote the reparation of sciatic nerve injury in vivo, especially for the reparation of the long-segment nerve. Progress in repair of sciatic nerve injury by BMSCs has been reviewed in this article.
Subject(s)
Humans , Bone Marrow Cells , Cell Biology , Physiology , Mesenchymal Stem Cells , Cell Biology , Physiology , Nerve Regeneration , Physiology , Peripheral Nerve Injuries , Therapeutics , Sciatic Nerve , Wounds and Injuries , Physiology , Stem Cell Transplantation , MethodsABSTRACT
Objective To investigate the plastic surgery of facial soft tissue for improvement of facial contour. Methods Botulinum toxin type A was injected into hypertrophied masseter to make it atrophy and attenuation; meanwhile, buccal fat lining was partly resected by intra-oral approach. Buc-cal liposuction was performed if necessary. Results 36 cases got satisfactory face thinning results af-ter treatment. The facial contour of all patients was markedly improved. Following up for 6 - 12 months showed that the effect was stable. Conclusion Plastic repair of facial soft tissue for improve-ment of facial contour is a simple approach, with mild injury, quick recovery, safe and effective.