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Objective:To investigate the possible role of non-invasive fibrosis scoring systems for detecting high-risk plaque among patients with non-alcoholic fatty liver disease (NAFLD).Methods:A total of 477 consecutive asymptomatic subjects underwent a health checkup including coronary computed tomography angiography (CTA) and abdominal ultrasonography. Fatty liver was evaluated using ultrasonography, and the NAFLD fibrosis score (NFS) was calculated. Coronary stenosis and plaque were evaluated using coronary CTA.Results:Of the study population, 223 had NAFLD. Among the NAFLD patients, high-risk coronary plaque was more frequent in patients with high or intermediate NFS than those with low NFS (62.5% versus 24.0%, P<0.001). The adjusted odds ratio with 95% confidence interval of high-risk plaque was 3.24 (1.11-9.40) for the highest versus lowest quartile of NFS ( P=0.016). Among those without NAFLD, NFS was not associated with high-risk coronary plaque (C-statistic with NFS versus without NFS, 0.766 versus 0.764, P=0.715). Adding NFS to the traditional cardiovascular disease (CVD) risk model increased the C-statistics by 0.679 to 0.739 ( P=0.031). Conclusions:There was an independent association of NFS with high-risk coronary plaque in patients with NAFLD, suggesting its potential use to optimize management of patients with NAFLD.
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Objective To analyze relevant clinical and dosimetric factors associated with radiation pneumonitis in patients with stage Ⅲ non-small cell lung cancer after they received radical radiotherapy.Methods A total of 126 patients with stage Ⅲ non-small cell lung cancer who received precision radiotherapy in Peking University Cancer Hospital were analyzed from January 2013 to December 2014.Data were collected including various clinical factors (including sex,age,histological type,tumor location,history of diabetes,history of hypertension,history of smoking,the season patients received treatment,ECOG performance status before treatment,chemotherapy before radiotherapy,concurrent chemotherapy and the classification of radiation pneumonitis),as well as related dosimetric parameters [including GTV,lung volume (LV),bilateral V5,V10,V20,V30 and MLD].SPSS 19.0 software was used to analyze the relation between correlation factors and radiation pneumonitis (RP≥2).Results Among the patients,31 cases (24.6％) had occurrance of radiation pneumonitis ≥ 2.Univariate analysis showed that age,ECOG performance status before treatment,concurrent chemotherapy and GTV/LV ratio were significantly correlated with RP ≥ 2 (R =0.157-0.222,P ＜ 0.05).Further multivariate Logistic regression showed that age,concurrent chemotherapy and GTV/LV ratio were significantly correlated (Wald =4.754,6.422,14.79,P ＜ 0.05).Conclusions In patients with stage Ⅲ non-small cell lung cancer after receiving thoracic radical radiotherapy,increasing age and GTV/LV ratio≥3.2％ are risk factors of RP≥2.The concurrent chemotherapy with low-dose paclitaxel might also increase the risk of RP≥2.
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Objective:To explore the influencing factors of recovering to normal atrioventricular nodal conduction (AVNC) in patients with acute myocardial infarction (AMI) complicated III atrioventricular block (AVB) .Meth‐ods:According to III AVB recovered to normal or not ,a total of 82 AMI complicated III AVB patients were divid‐ed into recovery group (n=51) and non- recovery group (n=31 ,including three cases undergoing permanent pace‐maker implantation and 28 dead cases) .The relationship among diabetes mellitus (DM) history ,ischemic precondi‐tioning (IP) ,levels of creatinine (Cr) and hemoglobin (Hb) at hospitalization ,systolic blood pressure (SBP) ,Killip class , cardiogenic shock and recovering to normal AVNC etc .were observed in two groups .Results:There were no significant difference in age ,sex proportion ,smoking history ,hypertension history ,DM history ,IP ,duration from onset to arriving at emergency room ,heart rate and SBP at hospitalization ,Hb level and early reperfusion treatment between two groups , P>0.05 all .Compared with recovery group ,there were significant rise in percentages of Kil‐lip ≥class II (39.2% vs .80.6% ) ,cardiogenic shock (21.6% vs .45.2% ) ,anterior wall infarction (7.8% vs . 32.3% ) ,Cr level [ (107.25 ± 6.69) μmol/L vs .(132.43 ± 11.52) μmol/L] and mortality (0% vs .90.3% ) ,and significant reduction in percentage of inferior wall infarction (92.2% vs .67.7% ) in non - recovery group , P<0.05 or < 0.01. Multifactor Logistic regression analysis indicated that Killip class was the independent predictor (OR=0.190 , P= 0.002 ) influencing recovering to normal AVNC in AMI + III°AVB patients .Conclusion:Killip class is an independent predictor influencing recovering to normal AVNC in AMI +III°AVB patients .
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Radiotherapy not only acts as an important local treatment of cancer, but also plays a key role in regulation of immune function. Radiotherapy regulates anti?tumor immune responses by promoting the generation of neoantigens, regulating the release of cytokine, and enhancing the sensitivity of tumor to cell?mediated immunity. Recently, several studies and clinical practice reported the abscopal effect in some patients undergoing radiotherapy combined with immunotherapy, which showed partial or complete response of metastases outside the irradiation field, suggesting the combination therapy as a promising strategy. However, further studies are needed for the understanding of the mechanism and influencing factors for immunity such as radiation dose and fractionation scheme. This paper reviews the research advances in the mechanism of radiotherapy?immunotherapy interaction and the combination therapy for cancer.
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Objective To evaluate the application of different assays for detection of human papillomavirus(HPV)in diagnosis of high grade cervical lesions.Methods Two hundred subjects with abnormal thinprep liquid-based cytology test(TCT)Resultswere selected for HPV DNA detection by hybrid capture 2(HC-Ⅱ) and Methodsbased on PCR including flow-through hybridization and gene chip (HybriMax),real-time fluorescent quantitative PCR(FQ-PCR)and flow fluorescent hybridization assay.Cytopathological Resultswere used as gold standards to evaluate the test performance of the above assays for diagnosing cervical intraepithelial neoplasia(CIN)≥Ⅱ. SPSS 13.0 software was used for statistical analysis.Results HPV DNA positive rates of 200 samples by HybriMax,FQ-PCR,flow fluorescent hybridization assay and HC-Ⅱ were 72.5%(145/200),71.5%(143/200),70.0%(140/200)and 69.0%(138/200),respectively,and the differences were not statistically si(g)nificant(x2 =0.252,0134,0.012 and 0.027,P ＞ 0.05).The sensitivity,Youden index and negative predictive value of the above assays were statistically different(x2 =7.923,7.819 and 8.108,P ＜0.05).Conclusion HC-Ⅱ is superior to PCR Methodsin diagnosis of CIN Ⅱ and above.