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Objective:To explore the risk factors affecting the incidence of acute kidney injury(AKI)after liver transplantation(LT).Methods:From November 2019 to November 2022, clinical data were retrospectively reviewed for 105 recipients of classic orthotopic LT.There are 89 males and 16 females with an age range of(50.52±10.35)years.They are assigned into two groups of AKI(66 cases)and non-AKI(39 cases)according to the AKI diagnostic and staging criteria of Global Kidney Disease Prognosis Organization in 2012.General profiles and clinical data(e.g.previous medical history, MELD score, total bilirubin, albumin, serum creatinine level, coagulation function, anhepatic phase and time to surgery)of two groups of recipients are compared.The factors with statistically significant differences are included into multivariate Logistic regression analysis for obtaining independent risk factors for early AKI post-LT.Results:Among them, 66 patients developed AKI within 7 days post-operation with an incidence rate of 62.86%(66/105).The clinical stages of AKI are Ⅰ(46 cases, 69.70%), Ⅱ(10 cases, 15.15%)and Ⅲ(10 cases, 15.15%).Statistically significant inter-group differences exists in age, abdominal surgery history, preoperative serum level of creatinine, operative duration, anhepatic phase and intraoperative plasma transfusion(all P<0.05).Multivariate Logistic regression analysis indicated that abdominal surgery history( OR=5.803, 95% CI: 1.008~33.401, P=0.049), anhepatic phase( OR=1.054, 95% CI: 1.008~1.101, P=0.020)and preoperative serum level of creatinine( OR=0.968, 95% CI: 0.943~0.994, P=0.016)are independent risk factors for early AKI after classical orthotopic LT recipients. Conclusions:Abdominal surgery history, anhepatic phase, and preoperative serum level of creatinine are independent risk factors for early AKI in classic orthotopic LT recipients.
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Objective:To investigate the relationship between serum retinol binding protein (RBP), stromal cell derived factor-1 (SDF-1) and renal function in patients with diabetic nephropathy (DKD).Methods:The patients with type 2 diabetes mellitus (T2DM) admitted to Yantai Affiliated Hospital of Binzhou Medical College from October 2017 to October 2020 were prospectively selected, 438 patients were divided into simple T2DM group ( n=276)and DKD group( n=162) according to the presence or absence of DKD, according to the ratio of urinary albinin/creatinine (UACR) were divided into normal( n=25), microalbuminuria ( n=75) and macroalbuminuria group ( n=62), according to the estimated glomerular filtration rate (eGFR) were divided into G1 stage ( n=28), G2 stage ( n=27), G3A + G3B stage ( n=35), G4 stage ( n=39)and G5 stages( n=33). The relationship between RBP, SDF-1 and renal function index UACR, serum uric acid (UA), blood urea nitrogen (BUN), β 2-microglobulin (β 2-MG) and serum creatinine (Scr) was analyzed. Measurement data of normal distribution were expressed as Mean± standard deviation ( Mean± SD). Independent sample t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups.Chi-square test was used to compare the enumeration data between groups. Receiver operating characteristic curve (ROC) was used to analyze the discriminant value of RBP and SDF-1 for DKD. Pearson was used for correlation analysis among indicators. Multivariate linear regression analysis was used to analyze the influencing factors of RBP. Results:In the DKD group, the duration of diabetes was longer, the levels of RBP, UACR, UA, BUN, β 2-MG, Scr were high, SDF-1 and eGFR were lower, with statistically significant differences compared with the simple T2DM group( P<0.05).The areas under the curve of RBP and SDF-1 to distinguish DKD were 0.903 and 0.868, and the optimal cut-off values was 70.71 mg/L and 5.69 ng/mL. With the increase of urinary albumin and clinical stage, the levels of RBP, UACR, UA, BUN, β 2-MG, Scr increased gradually, while SDF-1 and eGFR decreased gradually, and the differences were statistically significant ( P<0.05).RBP was positively correlated with UACR, UA, BUN, β 2-MG and Scr in DKD patients ( r=0.764, 0.787, 0.693, 0.577, 0.801, P<0.000 1), and negatively correlated with EGFR ( r=-0.782, P<0.000 1). SDF-1 was negatively correlated with UACR, UA, BUN, β 2-MG and Scr ( r=-0.744, -0.794, -0.666, -0.605, -0.820, P<0.000 1), and positively correlated with EGFR ( r=0.767, P<0.000 1). The multiple linear regression equation was RBP=29.852+ 0.007UACR+ 0.101UA+ 0.497BUN+ 0.034Scr-0.083eGFR ( P<0.001). Conclusion:RBP and SDF-1 have certain discriminant value for DKD patients in T2DM population, and the degree of DKD renal function injury is positively correlated with RBP and negatively correlated with SDF-1, the increase of UACR, UA, BUN, Scr and the decrease of eGFR are risk factors for the increase of RBP.
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Objective:To explore the expression of signal sequence receptor subunit 1 (SSR1) and its prognostic value in hepatocellular carcinoma.Methods:Search the expression data and relevant clinical data of SSR1 in hepatocellular carcinoma patients from the Cancer Genome Atlas (TCGA) database to June 20, 2021, and download relevant public data. The expression levels of SSR1 in 334 cases of hepatocellular carcinoma with complete information and data were analyzed retrospectively. The expression difference of SSR1 gene between hepatocellular carcinoma and adjacent tissues was analyzed by Wilcoxon signed rank test. Patients with hepatocellular carcinoma were divided into high expression group and low expression group based on the median value of SSR1 expression level (14.660). χ 2 test was conducted to analyze the relationship between SSR1 expression and clinicopathological features. Cox regression and Log-rank survival test were used to analyze the relationship between SSR1 gene expression, clinicopathological features and overall survival rate in patients with hepatocellular carcinoma. Univariate and multivariate Cox regression analysis were used to determine the factors affecting prognosis. Gene set enrichment analysis (GSEA) was used to predict the possible regulatory pathways. Result:Bioinformatics analysis based on TCGA database showed that the expression level of SSR1 in hepatocellular carcinoma (16.320±7.231) was significantly higher than that in normal liver tissue (7.473±1.410). The difference between groups was statistically significant ( t=8.621, P<0.001).The overall survival rate of patients with high SSR1 gene expression group was lower than that of patients with high SSR1 gene expression group (χ 2=10.1, P<0.001). The high expression of SSR1 gene was related to sex (χ 2=4.392, P=0.036), Stage (χ 2=6.264, P=0.012), T stage (χ 2=4.561, P=0.033) and Grade classification (χ 2=14.015, P<0.001). Multivariate Cox regression analysis showed that patients with high expression of SSR1 gene got worse risk of death ( HR=1.030, 95% CI:1.002-1.060, P=0.036), and SSR1 gene expression was an independent predictor of hepatocellular carcinoma. Gene set enrichment analysis showed that the high expression of SSR1 was related to ubiquitination, cell cycle, RNA degradation, mTOR signal pathway, Wnt signal pathway and MAPK signal pathway. Conclusion:SSR1 gene is significantly up-regulated in hepatocellular carcinoma, which is related to gender, Stage, T stage and Grade classification. Ubiquitination, cell cycle, RNA degradation, mTOR signal pathway, Wnt signal pathway and MAPK signal pathway may be the key pathways for SSR1 to promote the occurrence and development of hepatocellular carcinoma.
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Objective@#To detect the expression and the differential significance of CK5/6, DSG3, P40, TTF-1, CK7, NapsinA in small biopsy specimens of non-small cell lung cancer (NSCLC), squamous cell carcinoma (SCC) and adenocarcinoma (AC).@*Methods@#Immunohistochemical SP method was used to detect the expressions of CK5/6, DSG3, P40, TTF-1, CK7 and NapsinA in 120 small biopsy specimens of NSCLC hospitalized in the Central People's Hospital of Tengzhou from January 2016 to December 2017, and the results were analyzed combined with the clinical characteristics of NSCLC.@*Results@#The positive expression rates of CK5/6, DSG3 and P40 in lung SCC were 100.0%(56/56), 89.3%(50/56) and 96.4%(54/56), respectively, with specificity of 90.6%, 100.0% and 100.0%, respectively.The positive expression rates of NapsinA, TTF-1 and CK7 in lung AC were 81.3%(52/64), 90.6%(58/64) and 93.8%(60/64), respectively, with specificity of 100.0%, 92.9% and 96.4%, respectively.The positive expression rates of CK5/6, DSG3, P40 in SCC had statistically significant differences compared with those in AC (all P<0.05), and the expression of TTF-1, CK7 and NapsinA in AC had statistically significant differences compared with those in SCC (all P<0.05).@*Conclusion@#CK5/6, DSG3, P40, TTF-1, CK7 and NapsinA are of great significance in the differential diagnosis of SCC and AC in small biopsy specimens of NSCLC.
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Objective To detect the expression and the differential significance of CK 5／6,DSG3,P40,TTF-1,CK7,NapsinA in small biopsy specimens of non -small cell lung cancer ( NSCLC),squamous cell carcinoma (SCC) and adenocarcinoma (AC).Methods Immunohistochemical SP method was used to detect the expressions of CK5／6,DSG3,P40,TTF-1,CK7 and NapsinA in 120 small biopsy specimens of NSCLC hospitalized in the Central People's Hospital of Tengzhou from January 2016 to December 2017,and the results were analyzed combined with the clinical characteristics of NSCLC.Results The positive expression rates of CK5／6,DSG3 and P40 in lung SCC were 100.0%(56／56),89.3%(50／56) and 96.4%(54／56), respectively,with specificity of 90.6%,100.0% and 100.0%,respectively.The positive expression rates of NapsinA ,TTF-1 and CK7 in lung AC were 81.3%(52／64), 90.6%(58／64) and 93.8%(60／64),respectively,with specificity of 100.0%,92.9% and 96.4%,respectively. The positive expression rates of CK5／6,DSG3,P40 in SCC had statistically significant differences compared with those in AC (all P＜0.05),and the expression of TTF -1,CK7 and NapsinA in AC had statistically significant differences compared with those in SCC ( all P＜0.05).Conclusion CK5／6,DSG3,P40,TTF-1,CK7 and NapsinA are of great significance in the differential diagnosis of SCC and AC in small biopsy specimens of NSCLC .
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Objective:To explore the relationship between gene amplification status of human epidermal growth factor receptor 2 (HER2) and its clinicopathological features in breast cancer, and to analyze the affecting factors of axillary lymph node metastasis in breast cancer.Methods:The clinicopathological data of 262 patients with breast cancer at Tengzhou Central People's Hospital between January 2016 and March 2019 were collected, including age, tumor diameter, histological grade, pathological type, lymph node metastasis, tumor number, tumor location. The patients had routine pathology examination and the immunohistochemistry (IHC) result of HER2 was ++. The expressions of p53, Ki-67, estrogen receptor (ER), progesterone receptor (PR) were detected by using IHC. The gene amplification status of HER2 was detected by using fluorescence in situ hybridization (FISH). The relationship between gene amplification status of HER2 and clinicopathological features, the relationship between axillary lymph node metastasis and clinicopathological features was respectively analyzed.Results:HER2 gene amplification-positive was detected in 69 cases of 262 breast cancer patients, and the positive amplification rate was 26.3%. The gene amplification status of HER2 was correlated with Ki-67 proliferation index and the expression of ER as well as PR, and the differences were statistically significant (χ 2=13.27, P < 0.01; χ 2= 34.97, P < 0.01; χ 2=38.31, P < 0.01). There was no correlation with age, tumor diameter and other clinicopathological features (all P > 0.05). Among 262 cases of breast cancer, 106 (40.5%) cases had axillary lymph node metastasis. Lymph node metastasis was correlated with tumor diameter (χ 2=29.10, P < 0.01), and there was no correlation with other clinicopathological features (all P > 0.05). Conclusions:HER2 gene amplification of breast cancer is associated with Ki-67 proliferation index, the expression of ER and PR. The tumor diameter is a factor for affecting axillary lymph node metastasis. Accurate judgment of the above indicators can better guide the treatment and evaluate the prognosis of breast cancer.