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BACKGROUND@#Thyroid transcription factor-1 (TTF-1) has been widely studied in non-small cell lung cancer, which is considered as an independent prognostic factor in patiens with non-small cell lung cancer. However, there are few studies on the prognostic value of TTF-1 in small cell lung cancer (SCLC). The purpose of this study was to explore the relationship between the expression state of TTF-1 and the sensitivity to first-line chemotherapy and prognosis in patients with SCLC.@*METHODS@#A retrospective analysis was made on 234 patients with SCLC who were diagnosed and treated in The Affiliated Hospital of Qingdao University and received platinum-based chemotherapy. The clinical characteristics, treatment and survival of the patients were followed up. Chi χ² test and Logistic regression model were used to analyze the relationship between TTF-1 expression and chemotherapy response rate. Kaplan-Meier method and Cox proportional hazard regression model were used to analyze the effect of TTF-1 expression on survival time of patients.@*RESULTS@#Among the 234 patients, the positive expression of TTF-1 was 188 cases (80.3%), and the negative expression of TTF-1 was 46 cases (19.7%). The objective response rate (ORR) of first-line chemotherapy in patients with positive expression of TTF-1 was higher than that in patients with negative expression of TTF-1 (70.7% vs 47.8%) (χ²=8.681, P=0.003). Logistic regression multivariate analysis showed that the expression state of TTF-1 was an independent predictor of ORR in first-line chemotherapy (OR=0.216, 95%CI: 0.076-0.615, P=0.004), however this difference was only reflected in LS-SCLC. The median progression free survival (PFS) of patients with negative expression of TTF-1 was shorter than that of patients with positive expression (6.9 months vs 9.0 months) (χ²=9.357, P=0.002). The median OS in TTF-1 negative group was shorter than that in TTF-1 positive group (13.3 months vs 20.1 months)(χ²=12.082, P=0.001).@*CONCLUSIONS@#TTF-1 expression is an independent predictor of first-line chemotherapy response rate and survival in patients with SCLC, and may become a biomarker to predict the efficacy and prognosis of SCLC.
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Objective To analyze the clinical features of differentiated thyroid cancer diagnosed during pregnancy or one year after delivery.MethodsA total of 234 women with differentiated thyroid cancer were treated from January 2001 to January 2011.Cases were divided into three groups according to the time of tumor diagnosis( group 1,no pregnancy history; group 2,during pregnancy or in the first year after delivery;group 3,longer than 1 year after the delivery).ResultsThe thyroid nodule was asymptomatic and discovered on routine examination more often in group 2(78.7％ ) than other two groups (P =0.02).There were no significant difference among three groups in age,hospitalization time,operation time,operation method,tumor type,primary tumor stage and mortality. But more patients in group 2 were suffering from extrathyroid invasion ( P =0.024 ),multi-focal cancer ( P =0.023 ),larger cervical lymph node ( P =0.021 ),later regional lymph node stage (P =0.020 ) and higher local recurrence (P =0.001 ).By stepwise logistic regression analysis,pregnancy is one of the factors impacting on local recurrence rate ( P =0.045 ).ConclusionsPregnancy does not affect the mortality of the differentiated thyroid cancer,but the incidence of extrathyroid invasion,multi-focal cancer,cervical lymph node metastasis,local recurrence is higher in patients with differentiated thyroid cancer diagnosed during pregnancy.
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OBJECTIVE To investigate the relevant factors and drug sensitivity of Candida in nosocomial infection from a class A comprehensive hospital in Hangzhou in order to prevent and control nosocomial infection.METHODS We collected and identified clinic samples from inpatients during from Jan 2004 to Dec 2006 and drug resistance test was performed for Candida strains.The CHROMagar candida color medium and the Analytic Products Inc(API)20CAUX identification system were used to isolate and identify Candida strains from inpatients.The Etest was used to study the antifungal sensitivity.The data were analyzed by WHONET-5 software and were determined by the Clinical and Laboratory Standard Institute(CLSI)method.RESULTS Totally 264 strains of Candida were detected in the three years.The detection ratio in each year was 78 strains(29.5%),87 strains(32.9%),and 99 strains(37.5%),respectively.The C.albicans was the most commonly isolated species(65.5%)and then was C.tropicalis(15.1%)in all Candida species.The detection ratio was the highest in sputum samples(108 strains,40.9%)and the patients with respiratory tract infection(58 strains,22%).The results of antifungal drug sensitivity test showed that Candida were the most susceptive to amphotericin B,followed by fluconazole.The results of change showed that Candida remained stable susceptive to amphotericin B,but susceptive ratio to fluconazole was descent in the three years.CONCLUSIONS Candida in nosocomial infection are an increasing tendency and C.albicans is the commonest.Sensitivity of Candida to various antifungal drugs is different and there is a developing change in susceptive ratio to antifungal drugs.Strengthening supervising relevant factors and improving the immunity of organism are the main measures to prevent Candida in nosocomial infection.Antifungal drug should be used reasonably based on drug sensitive test.
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OBJECTIVE To study the value of the application of the neutrophil volume distribution width(NDW) in diagnosing acute bacterial infection generated by Coulter LH750 hematology analyzer.METHODS To do whole blood cell analysis of 80 blood samples of the bacteremic patients.Observed the white blood cell counts(WBC),the percentages of neutrophils,the value of the NDW and microscopic examination,to compare them with 50 controls.RESULTS A significant increase in the NDW was observed in the bacteremic patients compared with the controls(P