ABSTRACT
Objective:To investigate the application value of magnetic resonance dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) combined with microRNA-21 (miR-21) and miR-92a in the benign and malignant differentiation of bone tumors and the evaluation of their efficacy.Methods:A total of 120 patients with bone tumors were selected retrospectively from June 2018 to June 2019 in Panyu Hospital of Chinese Medicine, including 52 cases in the benign group and 68 cases in the malignant group. The DCE-MRI dynamic enhancement parameters and tumor tissue miR-21, miR-92a levels were compared between the two groups. The diagnostic value of DCE-MRI, miR-21, miR-92a levels of cancer tissue and their correlation were analyzed. Patients with bone malignant tumors were given comprehensive treatment. Six months after operation, according to the criteria of solid tumor curative effect, they were divided into good curative effect group and poor curative effect group. The DCE-MRI dynamic enhancement parameters [signal enhancement amplitude (SEE), early dynamic enhancement slope value (Slope), centripetal enhancement rate (DER)], miR-21, miR-92a levels of patients with different curative effects were compared.Results:The levels of SEE, Slope, DER and miR-21 a nd miR-92a in the malignant group were higher than those in the benign group ( P<0.05); The area under curve (AUC) of DCE-MRI, miR-21, miR-92a combined in the diagnosis of benign and malignant bone tumors (0.885)>Slope(0.808)>SEE(0.788)>miR-21(0.785)>miR-92a (0.740)>DER(0.660), with sensitivity 80.88%, specificity 88.46%, respectively; the DCE-MRI dynamic enhancement parameters SEE, Slope, DER were positively correlated with miR-21 and miR-92a ( P<0.05); the DCE-MRI dynamic enhancement parameters SEE, Slope, DER and miR-21, miR-92a of patients with good curative effect were lower than those with poor curative effect ( P<0.05). Conclusions:DCE-MRI dynamic enhancement parameters, miR-21, miR-92a levels are abnormally high expression in patients with bone malignant tumors, and combined detection is expected to become an important means to identify benign and malignant bone tumors and evaluate the efficacy.
ABSTRACT
Objective To investigate the relationship between (serum neutrophil gelatinase-associated lipocalin,sNGAL) and cardiovascular events in patients with chronic kidney disease(CKD).Methods 300 patients with CKD were divided into two groups according to the level of sNGAL:high sNGAL group (n=158) and low sNGAL group (n=142).The incidence of cardiovascular events and cumulative survival rate were analyzed by ROC curve,and the correlation between sNGAL and cardiovascular risk factors,cardiovascular events in patients with chronic renal disease was analyzed.Influencing factors of cardiovascular events in CKD patients was analyzed.Results There were significant differences in the data about BMI,diabetes proportion,CKD staging,eGFR,hsCRP,24h proteinuria,HDL,iPTH,phosphate and blood calcium between the two groups (P＜0.05).The 3-year cumulative survival rate of high sNGAL group(77.2％) was significantly lower than that of low sNGAL group(96.5％),and the 3-year incidence of cardiovascular events (37.9％) was significantly higher than that of low sNGAL group (9.8％) (P＜ 0.05).AUC in diagnosing cardiovascular events in high sNGAL group (0.746) was significantly higher than that in eGFR(0.636),age (0.504),serum calcium (0.545),HDL(0.594) and LDL (0.508,all P＜0.05).There was a significant correlation between sNGAL and eGFR,HDL,BMI,hs-CRP,iPTH and phosphate (P＜ 0.05).Both univariate and multivariate fact ors COX showed that sNGAL was a risk factor of cardiovascular events in patients with CKD (P＜0.05),((HR=1.976 and 1.588,95％ CI=1.443-2.724 and 1.144-2.143,respectively,P=0.O00 and 0.000)).Conclusions The incidence of cardiovascular events in patients with CKD with high sNGAL is significantly increased.sNGAL is an independent factor of cardiovascular events in patients with chronic renal disease.