Clinical features of hypopituitarism with nonalcoholic fatty liver disease after sellar tumor surgery in children / 临床肝胆病杂志

Objective To investigate the clinical features of hypopituitarism with nonalcoholic fatty liver disease (NAFLD) in children after sellar tumor surgery and the association between hypopitarism and NAFLD in children. Methods A retrospective analysis was performed for the clinical data of children with hypopituitarism and NAFLD after sellar tumor surgery who were followed up regularly in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2017 to December 2021, and their clinical features were analyzed. Results There were 32 children with regular follow-up and complete clinical data after sellar tumor surgery, and 10 children (31.25%) developed NAFLD, among whom there were 5 boys and 5 girls. Among these 10 children, 9 had craniopharyngioma and underwent surgical treatment, and 1 had germinoma and underwent local radiotherapy. The 10 children had a median age of 8.4(6.29.8) years at the diagnosis of hypopituitarism and a median age of 11.9(8.7-12.6) years at the diagnosis of NAFLD. The median number of years from the diagnosis of hypopituitarism to the diagnosis of NAFLD was 2.0(1.4-4.0) years. At the diagnosis of NAFLD, all 10 children had obesity, and body mass index (BMI) was increased by 7.26±4.25 kg/m 2 on average since the diagnosis of hypopituitarism; the 10 children had a mean fasting blood glucose level of 4.67±0.55 mmol/L, a mean fasting insulin level of 25.40±5.93 μIU/ml, and a mean HOMA-IR index of 5.26±1.29. Among these 10 children, 9 had hypertriglyceridemia, and 1 had elevated triglyceride, with a mean level of 3.08±1.09 mmol/L; 6 children had hypercholesterolemia, with a mean level of 5.67±1.25 mmol/L; 8 children had high-density lipoprotein cholesterolemia, with a mean level of 3.97±1.27 mmol/L. After the diagnosis of NAFLD, 2 children were treated with recombinant human growth hormone and metformin and achieved reductions in BMI, HOMA-IR, and triglyceride after treatment, and total cholesterol and low-density lipoprotein cholesterol were reduced to the normal range. Conclusion Children may experience weight gain, hypopituitarism, insulin resistance, and dyslipidemia after sellar tumor surgery, which may lead to the onset of NAFLD. Weight management and active pituitary hormone replacement therapy are recommended for such children, as well as routine screening and management of fatty liver disease.

Clinical and genetic analysis of a child with Schaaf-Yang syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics and genetic etiology of a child with Schaaf-Yang syndrome (SYS).@*METHODS@#Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing. Sanger sequencing was used for family constellation verification, and bioinformatic analysis was performed for the candidate variant.@*RESULTS@#The child, a 1-year-and-9-month-old boy, had clinical manifestations of retarded growth, small penis, and unusual facies. Genetic testing revealed that the child has harbored a novel heterozygous variant of c.3078dupG (p.Leu1027Valfs*28) of the MAGEL2 gene. Sanger sequencing showed that neither parent of the child carried the same variant. The c.3078dupG(p.Leu1027Valfs*28) variant of the MAGEL2 gene has not been included in the databases of ESP, 1000 Genomes and ExAC. According to the Standards and Guidelines for the Interpretation of Sequence Variants of the American College of Medical Genetics and Genomics (ACMG), the variant was judged to be pathogenic.@*CONCLUSION@#The c.3078dupG (p.Leu1027Valfs*28) variant of the MAGEL2 gene probably underlay the SYS in this child, which has further expanded the spectrum of the MAGEL2 gene variants.

Erratum: Author correction to "YPD-30, a prodrug of YPD-29B, is an oral small-molecule inhibitor targeting PD-L1 for the treatment of human cancer" Acta Pharmaceutica Sinica B 12 (2022) 2845-2858

[This corrects the article DOI: 10.1016/j.apsb.2022.02.031.].

Application and design of lymphoma dataset based on real-world research / 中华医学科研管理杂志

Objective:Considering the large amount and poor quality of clinical data, this study aims to explore the establishment of high-quality research database and its role in real-world research by taking the establishment of lymphoma research database as an example.Methods:The expert opinions in the field of lymphoma were collected, and the relevant guidelines and standards were referenced to establish a standard medical knowledge dataset. The electronic diagnosis and treatment data of lymphoma patients treated in Peking University Cancer Hospital from February 2005 to December 2020 were retrospectively extracted, the deep Learning, natural language processing were adopted to build a dynamic intelligent information integration and processing system of " lymphoma database based on electronic medical record system - biological sample information database - extended genetic information database" .Results:The research database not only meets the research needs of clinical researchers, but also realizes the management of traces in the whole process of application, approval, traceability and analysis of hospital medical record data and biological sample data. The total number of research variables in the database was 668, and the structured variables accounted for 46.0%. On December 25, 2021, there were 68 687 lymphoma patients in the database, the ratio of male to female patients was 8/9, and the proportion of patients with ≥3 visits accounted for 23.0%. In addition, researchers can superimpose searches in the database according to the target conditions, display the targeted medical records according to research hypothesis, and then establish a research cohort, conducting statistical modeling, and mining data information.Conclusions:By integrating management processes and using new natural language artificial intelligence technology to establish a high-level evidence-based database, it is helpful for the interconnection and resource sharing of hospital information systems, so as to achieve the purpose of providing reliable and detailed data for real-world research.

YPD-30, a prodrug of YPD-29B, is an oral small-molecule inhibitor targeting PD-L1 for the treatment of human cancer

PD-1 and PD-L1 antibodies have brought about extraordinary clinical benefits for cancer patients, and their indications are expanding incessantly. Currently, most PD-1/PD-L1 agents are administered intravenously, which may be uncomfortable for some cancer patients. Herein, we develop a novel oral-delivered small molecular, YPD-29B, which specifically targets human PD-L1. Our data suggested that YPD-29B could potently and selectively block the interaction between PD-L1 and PD-1, but did not inhibit any other immune checkpoints. Mechanistically, YPD-29B induced human PD-L1 dimerization and internalization, which subsequently activated T lymphocytes and therefore overcomes immunity tolerance in vitro. YDP-29B was modified as the YPD-30 prodrug to improve druggability. Using humanized mice with human PD-1 xenografts of human PD-L1 knock-in mouse MC38 cancer cells, we demonstrated that YPD-30 exhibited significant antitumor activity and was well tolerated in vivo. Taken together, our results indicate that YPD-30 serves as a promising therapeutic candidate for anti-human PD-L1 cancer immunotherapy.

The impact of obstructive sleep apnea on cardiac structure and function in elderly patients with type 2 diabetes mellitus / 中华老年医学杂志

Objective:To investigate the impact of obstructive sleep apnea(OSA)on cardiac structure and function in elderly patients with type 2 diabetes mellitus(T2DM).Methods:This was a case-control study.Elderly patients with T2DM aged 65 years and above at the Department of Geriatrics of Tianjin Medical University General Hospital were consecutively enrolled in this study, and eventually 61 patients with complete general information were included.All patients were examined with polysomnography(PSG). They were divided into the T2DM group and the T2DM+ OSA group based on whether there was concurrent OSA.Differences in cardiac structure and function were compared between the two groups and between patients with mild OSA and those with moderate-severe OSA.The correlation of OSA with cardiac structure and function in T2DM patients was analyzed by using Pearson correlation and multiple linear regression analysis.Results:The left ventricular ejection fraction(LVEF)was lower in the T2DM+ OSA group than in the T2DM group(52.38±4.70 % vs.56.34±5.92%, t=2.892, P=0.005). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness increased in the T2DM+ OSA group compared with the T2DM group(21.50±1.49 mm vs.20.55±1.05 mm, 10.21±0.88 mm vs.9.52±1.04 mm, 10.42±0.83 mm vs.9.83±0.83 mm, t=-2.670, -2.770 and -2.716, P=0.010, 0.007 and 0.009). LVEF was lower in patients with moderate-severe OSA than in those with mild OSA group(50.58±3.55% vs.55.83±4.83%, t=3.813, P=0.001). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness were greater in patients with moderate-severe OSA than in those with mild OSA(21.86±1.39 mm vs.20.79±1.46 mm, 10.48±0.82 mm vs.9.69±0.75 mm, 10.68±0.80 mm vs.9.92±0.64 mm, t=-2.231, -2.871 and -2.943, P=0.032, 0.007 and 0.006). Pearson correlation analysis showed that the Apnea Hypopnea Index(AHI)was correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( r=-0.425, 0.340, 0.458 and 0.473, P=0.001, 0.007, <0.001 and <0.001). After adjusting for age, body mass index, systolic blood pressure and triglycerides, multiple linear regression analysis showed that AHI was also correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( β=-0.385, 0.520, 0.604 and 0.388, P=0.036, 0.011, 0.001 and 0.039). Conclusions:OSA aggravates cardiac remodeling and systolic insufficiency in T2DM patients and may be related to the severity of intermittent hypoxia.

Relationship between obstructive sleep apnea and sarcopenia in the elderly / 中华老年医学杂志

Objective To explore the relationship between obstructive sleep apnea syndrome (OSA)and sarcopenia in elderly.Methods In the retrospective analysis,totally 320 elderly patients aged 65-85 years were successively enrolled from Department of Geriatrics,General Hospital of Tianjin Medical University from January 2015 to December 2017,and divided into the sarcopenia group (n=110) and the control group (n =210).Clinical and diagnostic data of OSA and sarcopenia were collected.The correlation between OSA and sarcopenia was evaluated by using multivariate Logistic regression.Results The average age was higher in the sarcopenia group than in the control group (P ＜ 0.001).Compared with the control group,the sarcopenia group had higher proportions of patients with male (P=0.015),with obesity,type 9 diabetes,dementia or OSA (P=0.005,0.021,0.032 and 0.018,respectively).Multivariate Logistic regression showed that risk factors for sarcopenia were age≥74.3 years (OR=1.63,95％CI:1.03～2.61),male (OR=1.79,95％CI:1.13 ～2.85),obesity (OR=1.70,95％CI:1.01～ 2.90),type 2 diabetes (OR=1.91,95％CI:1.11～3.29),dementia (OR=1.92,95％CI:1.05～3.49) and OSA (OR=2.24,95％CI:1.15～4.40)(P ＜0.001,0.015,0.038,0.021,0.032 and 0.018,respectively).OSA patients is more prone to sarcopenia than patients without OSA (OR =2,24,95 ％ CI:1.15 ～ 4.40).Conclusions OSA is correlated with sarcopenia in the elderly.

Liver and spleen stiffness in diagnosing esophageal varices and predicting high risk of esophageal and gastric varices bleeding / 中国医学影像技术

Objective To explore the value of liver and spleen stiffness in diagnosing esophageal and gastric varices (EGV) and predicting high risk of EGV bleeding in patients with hepatitis B virus (HBV)-related liver cirrhosis.Methods Totally 71 patients with HBV-related liver cirrhosis who had undergone endoscopy were prospectively recruited.Then acoustic radiation force imaging (ARFI) was performed.The severity of EGV was graded and ROCs were drawn on the liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) to detect the value of liver and spleen stiffness in diagnosing EGV and predicting the high risk of EGV bleeding.Results There were significant differences of LSWV and SSWV between patients with EGV and without EGV (all P＜0.001).Taking endoscopy results as golden standards,the areas under ROC curve of LSWV and SSWV were 0.877 and 0.910 (both P＜0.001) in diagnosing esophageal varices,and the optimal cut-off values were 2.01 m/s and 2.84 m/s (sensitivity 93.5％ and 76.1％,specificity 76.0％ and 92.0％),respectively.Areas under ROC curve of LSWV and SSWV in predicting the high risk of EGV bleeding were 0.882 and 0.914 (both P＜0.001),and the optimal cut-off values were 2.27 m/s and 2.94 m/s (sensitivity 77.1％ and 85.7％,specificity 83.3％ and 91.7％),respectively.Conclusion Liver and spleen stiffness are useful in diagnosing EGV and predicting the high risk of EGV bleeding in patients with HBV-related liver cirrhosis.

The predictive value of brain natriuretic peptide for acute decompensated heart failure in rehospitalized elderly patients / 中华老年医学杂志

Objective To evaluate changes in brain natriuretic peptide(BNP)levels in predicting the risk of acute decompensated heart failure(ADHF)in rehospitalized elderly patients.Methods A cohort study was performed in 48 elderly(≥65 years)patients hospitalized for ADHF from June 2015 to June 2016.All patients underwent standard treatment in internal medicine and were followed up for one month after discharge.The study endpoint was rehospitalization for ADHF.According to whether there was an increase in BNP levels in one-month follow-up,participants were divided into two groups:a group with increased BNP (n =20) and a group without increased BNP (n =28).General clinical information,disease history,signs of circulatory congestion,cardiac ultrasound,and BNP levels were collected and compared between the two groups.Results Compared with the group without increased BNP,the group with increased BNP had higher rates of type 2 diabetes,positive hepatoj ugular reflu x,and jugular vein engorgement (x 2 =5.749,7.243,4.286,respectively,P ＜0.05 or P ＜0.01)and lower left ventricular ejection fraction(t =-3.558,P ＜0.01).BNP increase in the BNP group was higher than in the non-BNP group(394.2 ± 171.3 ng/L vs.94.2 ± 56.3 ng/L,P ＜0.01).The rehospitalizationrate in the BNP group was significantly higher than in the non-BNP group(55 ％ or 11 patients vs.17.8％ or 5 patients,P＜0.01).Multivariate Cox regression analysis found that the increase in BNP in the one-month follow-up was correlated with the increase in rehospitalization(HR =4.118,95％CI:1.427-11.884,P＜0.01).When the absolute value of BNP rose to over 310ng/L,the risk of rehospitalization in ADHF patients increased.Conclusions Increase in BNP one month after discharges is an effective predictor for rehospitalization in elderly patients with ADHF.

Effects of Aging on the Proliferation and Differentiation Capacity of Human Periodontal Ligament Stem Cells / 中国医学科学杂志(英文版)

Objective The aim of this study is to investigate the proliferation, differentiation and apoptosis of periodontal ligament stem cells (PDLSC) derived from different aged donors, and to evaluate the effects of aging on the biological characteristics of PDLSC.Methods Periodontal ligament tissues were obtained from 24 surgically extracted human premolars during orthodontics therapy. The specimens were divided into three groups according to the donor's age. Group A: 18-20 years, group B: 30-35 years, group C: 45-50 years. PDLSC were isolated and cultured using a tissue-block-based enzymolytic method by limiting dilution assay. The colony forming efficiency of PDLSC for three experimental groups was determined. Senescence-Associated β-Galactosidase (SA-β-G) expression in the three groups was examined using β-galactosidase staining working solution. Cell cycle and apoptosis of the PDLSC were examined by the flow cytometry. Alkaline phosphatase (ALP) activity was evaluated by ALP staining. The expression of osteoplastic differentiation related genes Runt-related transcription factor-2 (Runx-2), Collagen Type 1 (col-1), and ALP of PDLSC were examined by quantitative real-time RT-PCR.Results The colony forming efficiency of PDLSC in Group A, B and C was 36.67%, 22.67% and 9.33%, respectively, which decreased with donors' age (P<0.05). SA-β-G expression of the senescent PDLSC in group A, B and C were 4.14%, 16.39%, 50.38%, respectively (P<0.05). Cells in G2/S phase was 38.73%, 29.88%, 18.25% (P<0.05), and the apoptosis rate was 1.57%, 4.56%, 5.84% (P<0.05), in group A, B and C respectively. The ALP staining in the three groups decreased with the increase of donors' ages, and the expression of Runx-2, col-1 and ALP decreased gradually from group A to group C (all P<0.05), which indicated the osteogenic differentiation capacity of PDLSC decreased while donor aging.Conclusion Human PDLSC could be successfully isolated from periodontal ligament tissues of different aged donors. However, the proliferation and osteogenic differentiation capacity of PDLSC decreased while donor aging.

Comparison of prognostic models for patients with early-stage diffuse large B-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To compare the prognostic value of different models in patients with early-stage diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>Early-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively. All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with or without radiotherapy. The prognostic value of international prognostic index (IPI) , revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared.</p><p><b>RESULTS</b>Ninety-seven cases of early-stage DLBCL were included in the study. The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months). The expected 5-year overall survival (OS) for entire group was 82%. There was no patient in the high risk group according to IPI or NCCN-IPI. According to IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 95%, 38% and 60%, respectively. According to R-IPI, the 5-year OS in the very good, good, and poor risk groups were 93%, 75% and 60%, respectively. According to NCCN-IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 92%, 85% and 29%, respectively.</p><p><b>CONCLUSION</b>NCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.</p>

The diagnostic value of ultrasound elastography and acoustic radiation force impulse imaging in solitary solid thyroid nodule / 天津医药

Objective To evaluate the diagnostic values of ultrasound elastography (UE) technology and acoustic radia?tion force impulse (ARFI) technology in the differential diagnosis of benign and malignant single solid thyroid nodule showed by ultrasonography. Methods A total of 100 patients with solitary thyroid nodule diagnosed by the Affiliated Hospital, School of Medicine of Shihezi University in December 2013 to July 2014 were selected in this study. The routine ultrasound, UE examination and ARFI technology were used in patients before operation. All patients were performed operation for thy?roid nodules and the diagnosis was confirmed by the pathologic results. A flexible classification method was used in UE. ARFI was used to detect shear wave velocity (SWV) of lesions. The diagnostic values of three methods were evaluated by the gold standard of pathologic results. ROC curves were plotted according to SWV values of benign and malignant thyroid nod?ules. Results The area under the curve (ACU) was 0.960. The best cut-off value of SWV was 2.76 for diagnosis. The diag?nostic sensitivities of malignant thyroid solid nodules were 82.61%(19/23), 82.61%(19/23) and 91.30%(21/23) for US, UE and ARFI, respectively. The diagnostic specificities were 87.01%(67/77), 88.31%(68/77) and 93.51%(72/77) respectively. And the positive predictive values (PPV) were 65.52%(19/29), 67.86%(19/28) and 80.77%(21/27) respectively;the nega?tive predictive values (NPV) were 94.37%(67/71),94.44%(68/72) and 97.29%(71/73). Conclusion ARFI technology is superior to US and UE technology in predicting malignancy in solitary solid thyroid nodule, which is worth of clinical applica?tion and promotion.

Correlation btween IgG4, TGF-β1, CTGF and fibrosis in Hashimoto thyroiditis / 中华检验医学杂志

Objective To explore the correlation among serum immunoglobulin G4 (IgG4),transforming growth factor-β1 (TGF-β1),connective tissue growth factor (CTGF) and Hashimoto thyroiditis (HT) thyroid fibrosis.Methods Case-control study.A total of 159 patients with HT visiting the Wuhan Union Hospital were collected from May 2013 to March 2015.All patients were divided into IgG4 HT group (IgG4≥1.35 g/L,n =39) and non-IgG4 HT group (IgG4 ＜ 1.35 g/L,n =120).The serum IgG4,TGF-β1 and CTGF were determined by enzyme-linked immunosorbent assays.The levels of serum thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured by electrochemiluminescence immunoassay.Meanwhile,ultrasound of the thyroid gland was performed.Statistical analysis was performed by use of SPSS 17.0 software.The Mann-Whitney U test was used to compare two independent samples of non-normal distribution data,Fisher's exact test was employed to analyze thyroid imaging differences,correlation test was performed to examine various correlations,multivariate Logistic regression analysis was used to evaluate thyroid fibrosis risk factors.Results Compared with that of non-IgG4 HT group,IgG4 HT group:TPOAb [(455.2 ± 169.7) vs.(186.5 ± 102.3),U =27.0,P=0.003],TgAb [(984.6±452.7) vs.(289.3 ±245.1),U=30.5,P=0.017],TGF-β1 [(1.45±0.97) vs.(0.30±0.22),U=119.0,P=0.035] andCTGF [(88.65±14.39) vs.(62.21± 8.76),U =69.0,P =0.039] were significantly higher,thyroid ultrasound showed obvious fibrosis (35/4 vs.32/88,x2 =48.03,P =0.000);significant positive linear correlation between IgG4 and TPOAb (r =0.719,P =0.000),CTGF and TGF-β1 (r =0.500,P ＜ 0.01) respectively.Logistic regression analysis indicated that all the serum IgG4,TPOAb,TGF-β1 and CTGF were independent risk factors of thyroid fibrosis [IgG4,odds ratio (OR) =1.968,P =0.014,95％ confidence interval (CI) =1.287-2.041;TPOAb,OR =2.537,P =0.012,CI =1.322-2.869;TGF-β1,OR =1.549,P =0.023,CI =1.105-1.498;CTGF,OR =1.185,P =0.046,CI =1.204-1.625].Conclusion The highlevel of circulating antibodies,IgG4,TGF-β1 and CTGF were significantly associated with thyroid fibrosis,and were independent risk factors of HT fibrosis.

Clinical significance of IgG4 related Hashimoto thyroiditis / 中国免疫学杂志

Objective:To explore the serum IgG4 level in patients with IgG4-related Hashimoto thyroiditis(IgG4 HT),and its clinical implications.Methods:The serum IgG4 was determined in 129 patients with HT using enzyme-linked immunosorbent assays and classified into two subgroups based on IgG4 level:IgG4 HT group(IgG4≥135 mg/dl)and non-IgG4 HT group(IgG4<135 mg/dl).And the levels of serum thyroid hormone and thyroid peroxidase antibodies(TPOAb)and thyroglobulin antibodies(TgAb)were measured by electro-chemiluminescence immunoassay.Ultrasonic imaging of the thyroid gland were detected.Results:The TPOAb levels correlated significantly with both serum IgG4 levels(r=0.437 1,P=0.012 7)and IgG4/IgG ratios(r=0.396 2,P=0.023 5)in the patients with HT.Compared with that of non-IgG4 HT group(n=97),IgG4 HT group(n=32):①The mean age was lower(P=0.029 3);②Higher levels of serum TPOAb(P=0.002 1)and TgAb(P=0.012 8);③Ultrasound imaging:the more obvious thyroid nodule(P=0.022 6);④Logistic regression analysis showed that serum IgG4 and TPOAb were the risk factor for thyroid nodules(OR=1.672,P=0.021;2.549,P=0.014 ).Conclusion: IgG4 HT patients existed corresponding clinical characteristics.For the HT-patients with elevated serum IgG4,thyroid function and morphology should were more closely monitored.

Expression and prognostic value of COX- 2, p16(INK4A) and p53 in patients with classical Hodgkin lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the expression level of COX-2, p16(INK4A) and p53 in patients with classic Hodgkin's lymphoma (cHL), and to evaluate their correlation with prognosis.</p><p><b>METHODS</b>The clinical data and samples of 52 cHL cases were collected. Immunohistochemical staining was performed to analyze the proteins level mentioned above and in situ hybridization of EBV encoded RNA (EBER) to clarify the tumor EBV infection state. Correlation between the protein expression and prognosis of patients was analyzed.</p><p><b>RESULTS</b>Of 52 cases, the male and female ratio was 1.6∶1, the age was from 22 to 68 years old. All lesions located primarily in lymph nodes. All samples from 52 cases were stained with COX-2, p16(INK4A) and p53, and the positive expression of COX-2 was found in 28 cases (53.8%）, that of p16(INK4A) in 25 cases (48.1%)and p53 in 42 cases (80.8%）. All patients were divided into two groups according to differences in age (<40 years/ ≥ 40 years), gender (male/female), EBV infection (yes/no), B symptoms (yes/no), and the Ann Arbor staging (Ⅰ-Ⅱ/Ⅲ-Ⅳ), the correlation with COX-2, p16(INK4A) and p53 expression were analyzed, and only p53 expression was correlated with Ann Arbor staging (P=0.027). The statistical analysis of correlations between COX- 2, p16(INK4A) and p53 showed that the expression of COX-2 was strongly correlated with p53 (P=0.008), and p16 (INK4A) was not related to either COX-2 or p53 (P=0.246 and 0.958). Kaplan- Meier univariate OS analysis using SPSS17.0 software showed that only COX-2 expression was an adverse prognostic factor for patients'event free survival (EFS) (P=0.003). Meanwhile COX-2 expression was a unique independent prognostic factor analyzed by COX proportional hazards regression model (HR=0.091, 95% CI 0.017-0.505, P=0.006).</p><p><b>CONCLUSION</b>The expression rate of COX-2, p16 (INK4A) and p53 in the cHL were relatively high; and they were not statistically correlated with tumor EBV infection status; the COX-2 positive group had poor prognosis, but only event free survival time becomes statistically significant shorter. COX proportional hazard regression model was used to analyze the COX-2 expression as a independent adverse prognostic factors for EFS.</p>

Utility of HbA1C in diagnosing diabetes in subjects with hypertension / 中华内分泌代谢杂志

To evaluate the efficacy of HbA1C in diagnosing diabetes in subjects with primary hypertension.The results demonstrated that the area under the reciever operating characteristic ( ROC ) curve was 0.895,with corresponding sensitivity of 85.4％,and specificity of 82.2％,when the optimal cutpoint of HbA1C in diagnosing diabetes was 6.0％.Our study suggested that HbA1C ≥6.0％ can be used efficiently in diagnosing diabetes in patients with primary hypertension.