Study on the prognostic influencing factors of esophageal squamous cell carcinoma and the predictive value of inflammatory reaction indexes on its postoperative recurrence / 中华肿瘤杂志

Objective: To explore the influence factors of poor prognosis of esophageal squamous cell carcinoma (ESCC) and the predictive value of inflammatory reaction indexes including neutrophils and lymphocytes ratio (NLR), platelet and lymphocyte ratio (PLR), monocyte and lymphocyte ratio (MLR) provision and differentiation degree, infiltration depth, lymph node metastasis number on the postoperative recurrence of ESCC. Methods: A total of 130 patients with ESCC who underwent radical resection from February 2017 to February 2019 in Nanyang Central Hospital were selected and divided into good prognosis group (66 cases) and poor prognosis group (64 cases) according to the prognostic effect. The clinical data and follow-up data were collected. Multivariate logistic regression analysis was used to determine the independent influencing factors of poor prognosis. Spearman correlation analysis was used to determine the correlation between preoperative NLR, PLR and MLR with the degree of differentiation, depth of invasion and number of lymph node metastases. Receiver operating characteristic (ROC) curve analysis was used to evaluate the efficacy of NLR, PLR and MLR in predicting poor prognosis of ESCC. Results: Univariate analysis showed that the degree of differentiation, the degree of invasion and the number of lymph node metastasis were related to the prognoses of patients with ESCC (P<0.05). Multivariate logistic regression analysis showed that the degree of differentiation, depth of invasion and number of lymph node metastases were independent influencing factors for poor prognosis of patients with ESCC, moderate differentiation (OR=2.603, 95% CI: 1.009-6.715) or low differentiation (OR=9.909, 95% CI: 3.097-31.706), infiltrating into fibrous membrane (OR=14.331, 95% CI: 1.333-154.104) or surrounding tissue (OR=23.368, 95% CI: 1.466-372.578), the number of lymph node metastases ≥ 3 (OR=9.225, 95% CI: 1.693-50.263) indicated poor prognosis. Spearman correlation analysis showed that NLR was negatively correlated with the degree of differentiation and the number of lymph node metastases (r=-0.281, P=0.001; r=-0.257, P=0.003), PLR was negatively correlated with the degree of differentiation, depth of invasion and number of lymph node metastasis (r=-0.250, P=0.004; r=0.197, P=0.025; r=-0.194, P=0.027), MLR was positively correlated with the degree of differentiation and the number of lymph node metastasis (r=0.248, P=0.004; r=0.196, P=0.025). ROC curve analysis showed that the areas under the curve of NLR, PLR and MLR in predicting poor prognosis of ESCC were 0.971, 0.925 and 0.834, respectively. The best cut-off value of NLR was 2.87. The sensitivity and specificity of NLR in predicting poor prognosis of ESCC were 90.6% and 87.9%, respectively. The optimal cut-off value of PLR was 141.75. The sensitivity and specificity for predicting poor prognosis of ESCC were 92.2% and 87.9%, respectively. The best cut-off value of MLR was 0.40. The sensitivity and specificity of MLR in predicting poor prognosis of esophageal squamous cell carcinoma were 54.7% and 100.0%, respectively. Conclusions: The degree of differentiation, the degree of invasion and the number of lymph node metastases are closely related to the poor prognosis of patients with esophageal squamous cell carcinoma. NLR, PLR and MLR can provide important information for predicting the poor prognosis of esophageal squamous cell carcinoma.

Effect of vacuum drainage on the blood circulation of expanded flap in ear reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of vacuum drainage on blood circulation of expanded skin flap, so as to confirm suitable negative pressure for ear reconstruction.</p><p><b>METHODS</b>21 patients (Auricular Reconstructive Center of Plastic Surgery Hospital, PUMC) were randomly divided into A, B, C 3 groups to receive vacuum drainage of: -20, -40 and -60 kPa, respectively. The length and width of reconstructed ears,which represented the swelling degree, were measured instantly and 5, 10 days postoperatively. The changes were calculated and reflected venous drainage of flaps. The temperature of proximal (concha) and distal (helix) part of the expanded flaps, which represented the arterial blood supply of flaps, was detected by infrared thermography after operation.</p><p><b>RESULTS</b>Five days after operation [(1.48 +/- 0.47) mm, (0.36 +/- 0.06) mm] and immediately [(1.67 +/- 0.69) mm, (0.40 +/- 0.16) mm)] , the changes of the length and width of reconstructed ear in group B was significantly low, while there was no statistically difference between group A and C (P > 0.05). The data between 10 days and 5 days after operation showed the same result. Along with the increase of the negative pressure, the swelling degree of reconstructed ears decreased firstly and then increased reversely ( P < 0.01 ). The flap temperature of reconstructed ears increased (P < 0.01), especially in proximal (concha) part (P < 0.01) , when the negative pressure increased (0 to -60 kPa).</p><p><b>CONCLUSIONS</b>Vacuum drainage has effect on both the venous drainage and blood supply. Negative pressure of -40 kPa can improve both the blood supply and venous drainage. It should be as reference for clinical application.</p>

The association between paternal age and schizophrenia in a Chinese Han population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate whether advanced paternal age is related to an increased risk of schizophrenia in Chinese Han population.</p><p><b>METHODS</b>A case-control design study was performed. Three hundred and fifty-one patients with schizophrenia and 199 unrelated healthy volunteers were recruited. By using Logistic regression, paternal age was divided into five categories, and maternal age into four categories. Setting the paternal age of 26-30 years as reference, the OR, P values and 95% CI of the other paternal age categories were analyzed, respectively. The participant's sex, age and parental age at birth were used as covariants for adjusting confounding effects.</p><p><b>RESULTS</b>The OR for schizophrenia in offspring whose paternal age at birth of 31-35 years, 36-40 years, and ≥ 41 years categories were 3.834, 8.805, and 11.619 respectively. The advanced maternal age had no significant effects on the risk for schizophrenia in offspring.</p><p><b>CONCLUSION</b>The advanced paternal age was associated with elevated risk for schizophrenia in offspring among a Han Chinese population. Putative biological mechanisms may include accumulated de novo mutations and alterations in epigenetic regulations with aging in spermatogenesis.</p>

Application of the Children' s Impact of Event Scale (Chinese Version) on a rapid assessment of posttraumatic stress disorder among children from the Wenchuan earthquake area / 中华流行病学杂志

Objective To explore the reliability and validity of the Children' s Impact of Event Scale (Chinese version, CRIES-13) and to determine the value and the optimal cutoff point of the score of CRIES-13 in screening posttraumatic stress disorder(PTSD), so as to provide evidence for PTSD prevention and identify children at risk in Wenchuan earthquake areas. Methods A total of 253 children experienced the Wenchuan earthquake were tested through Stratified random cluster sampling. The authors examined CRIES-13's internal consistency, discriminative validity and predictive value of the cut-off. PTSD was assessed with the DSM-Ⅳ criteria. Area under the curve while sensitivity, specificity and Youden index were computed based on the receiver operating characteristic curve analysis. Optimal cutoff point was determined by the maximum of Youden index. Results 20.9% of the subjects were found to have met the DSM-Ⅳ criteria for PTSD 7 months after the Wenchuan earthquake accident. The Cronbach' s coefficient of CRIES-13 was 0.903 and the mean inter-item correlation coefficients ranged from 0.283 to 0.689, the correlation coefficient of the three factors with the total scale scores ranged from 0.836 to 0.868 while the correlation coefficient among the three factors ranged from 0.568 to 0.718, PTSD cases indicated much higher scores than non-PTSD cases, the Youden index reached maximum value when the total score approached 18 in CRIES-13 with sensitivity and specificity as 81.1% and 76.5% respectively. Consistency check showed that there were no significant differences between the results of CRIES-13 score ≥32 and clinical diagnosis (Kappa=0.529) from the screening program. Conclusion CRIES-13 appeared to be a reliable and valid measure for assessing the posttraumatic stress symptoms among children after the earthquake accident in the Wenchuan area. The CRIES-13 seemed to be a useful self-rating diagnostic instrument for survivors with PTSD symptoms as a clinical concern by using a 18 cut-off in total score. Consistency check showed that there was no significant difference between the screening result of CRIES- 13 score ≥ 32 and clinical diagnosis.

Advances in the studies of the dysbindin gene in schizophrenia / 中华医学遗传学杂志

Recent reports indicate that the dysbindin gene located on chromosome 6p22.3 is a major susceptibility gene for schizophrenia. In the brain, the dysbindin gene may influence glutamatergic neurotransmission by multiple post- and pr- synaptic mechanisms. This paper reviews the research progress on the dysbindin gene in schizophrenia, including the dysbindin gene and its product, the possible pathogenic mechanisms, the association study of the dysbindin gene with schizophrenia, and the cognitive decline caused by the dysbind in variations.

Oncosis in human esophageal squamous cell carcinoma and its relationship with apoptosis and microvessel density / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies have shown that oncosis in malignant tumors might be related to cellular energy supply. The aim of this study was to detect oncosis in human esophageal squamous cell carcinoma (ESCC), and to investigate its relationship with apoptosis and microvessel density (MVD).</p><p><b>METHODS</b>ESCC specimens were obtained from 30 patients with ESCC after surgery. Transmission electron microscopy, TUNEL, and immunohistochemistry were used to detect oncosis, apoptosis, and MVD. The relation of oncosis to apoptosis and MVD was analyzed by ANOVA, t test, and q test using SPSS 10.0.</p><p><b>RESULTS</b>Transmission electron microscopy revealed both oncosis and apoptosis in the ECSS tissues. About 10% of the TUNEL-positive cells, which were considered apoptotic cells, showed the characteristics of oncosis. In the areas, where oncotic cells accumulated, apoptotic cells were rare; contrarily, where apoptotic cells gathered, oncotic cells were sparse. Compared with the tissues with a high MVD, the number of oncotic cells was increased and that of apoptotic cells was decreased in the tissues with a low MVD.</p><p><b>CONCLUSIONS</b>Cellular oncosis can be detected in human ESCC tissues. The distribution of oncotic cells presents a close relationship with cellular apoptosis and MVD. Oncosis might be induced by poor blood supply.</p>

Cloning of A73 gene and its coding sequence analysis / 南方医科大学学报

<p><b>OBJECTIVE</b>To clone A73 gene of Epstein-Barr virus (EBV) and examine the variation of its coding sequence.</p><p><b>METHODS</b>A73 coding sequence (CDS) amplified from 7 patients in nasophryngeal carcinoma (NPC) biopsies by RT-PCR was cloned into pGEM-T-Easy vector to construct the recombinant plasmid, which was subjected to sequence analysis in Gen Bank database using Blast software.</p><p><b>RESULTS</b>A73 gene from nasophryngeal carcinoma was successfully cloned into pGEM-T Easy vector. A locus with conversion of A-->C in A73 was found at CDS 45 nt, located in the exonVB157154 nt, which did not result in an amino acid replacement, and the variation frequency was 7/7.</p><p><b>CONCLUSION</b>There is a point mutation in A73 CDS of EBV isolated from NPC tissue, which might produce NPC-associated polymorphism with possible involvement in the composition of some subtype of EB virus.</p>

Effects of oxidized low density lipoprotein on the growth of human artery smooth muscle cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Studies have shown that oxidized low density lipoprotein (ox-LDL) promotes the pathogenesis and development of atherosclerosis (AS), and that the proliferation, migration and phenotype alteration of vascular smooth muscle cells (vSMCs) into foam cells are critical changes in AS. It is proposed that ox-LDL might play a novel role in the pathologic process of vSMCs. The present study was performed ex vivo to investigate the effects of ox-LDL on the growth of cultured human vSMCs.</p><p><b>METHODS</b>Using NaBr density gradient centrifugation, LDL from human plasma was isolated and purified. ox-LDL was produced from LDL after being incubated with CuSO4. ox-LDL was then added to the culture medium at different concentrations (25 microg/ml, 50 microg/ml, 75 microg/ml, 100 microg/ml, 125 microg/ml, and 150 microg/ml) for 7 days. The influence of ox-LDL on vSMC growth was observed from several aspects as growth curve, mitosis index, lipid staining, and in situ determination of apoptosis. The digital results were analyzed with SPSS 10.0.</p><p><b>RESULTS</b>The ox-LDL produced ex vivo had a good purity and optimal oxidative degree, which was similar to the intrinsic ox-LDL in atherosclerotic plaque. ox-LDL at a concentration of 25 microg/ml demonstrated the strongest proliferation. At the concentration of 125 microg/ml, ox-LDL suppressed the growth of vSMCs. At concentrations of 25 microg/ml and 50 microg/ml, ox-LDL presented powerful mitotic trigger. When the concentration of ox-LDL increased, the mitotic index of vSMCs decreased gradually. ox-LDL induced more foam cells from vSMCs with rich intracellular lipid accumulation at concentrations of 25 microg/ml and 50 microg/ml. ox-LDL at higher concentrations induced more apoptotic vSMCs.</p><p><b>CONCLUSIONS</b>ox-LDL at lower concentrations may trigger proliferation and phenotype alteration into foam cells of vSMCs, and at higher concentrations it may induce apoptosis in vSMCs. ox-LDL plays an important role in the pathogenesis and development of atherosclerosis by its effect on vSMCs proliferation, phenotype alteration and apoptosis.</p>