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With the breakthrough of immune checkpoint blocking therapy in the clinical treatment of a variety of malignant solid tumors, tumor immunotherapy has opened a new era. However, clinical practice has proved that the response rate of this therapy is low. Seeking for the key factors limiting its response rate has become a research hotspot in this field. Programmed death ligand 2 (PD-L2) is the second important ligand binding to programmed death 1 (PD-1) after programmed death ligand 1 (PD-L1). The encoded protein can bind to PD-1 and then inhibit immune cells. This paper reviews the biological characteristics of PD-L2, its mechanism in immune regulation and its research progress in solid tumor immunotherapy to provide more theoretical support for solid tumor immunotherapy.
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Objective:To investigate the clinical therapeutic effect of low-dose chemotherapy in advanced gastrointestinal cancer patients with weak physical condition, and to evaluate the related factors affecting the prognosis.Methods:The clinical data of 118 advanced gastrointestinal cancer patients with weak physical condition who were admitted to Xiamen Branch, Zhongshan Hospital, Fudan University from March 2018 to May 2019 were retrospectively analyzed. Kaplan-Meier method was used to make survival analysis in patients stratified by different factors, and log-rank was used to test. Multiple factor analysis of prognosis was performed by using Cox regression model. The association of clinicopathological factors with the prognosis was evaluated.Results:Among 118 patients, 16 (13.6%) cases were esophageal cancer, 41 (34.7%) cases were gastric cancer, 48 (40.7%) cases were colorectal cancer, 13 (11.0%) cases were pancreatic cancer. The overall survival (OS) rates of 6 months and 1-year were 44.1% and 10.2%, respectively. Survival analysis showed that patients with hemoglobin ≥100 g/L, serum albumin > 40 g/L and normal gastrointestinal function had better OS (all P < 0.05), while patients with physical status score of 3 scores and pain had worse OS (all P < 0.05). Cox multivariate analysis showed that after adjusting age and gender, hemoglobin level ( HR = 0.314, 95% CI 0.241-0.977, P = 0.001), pain ( HR = 2.016, 95% CI 1.697-7.038, P = 0.008) and gastrointestinal function ( HR = 1.751, 95% CI 1.607-6.080, P = 0.036) were independent influencing factors of OS in advanced gastrointestinal cancer patients with weak physical condition after receiving low-dose chemotherapy. Conclusions:Low-dose chemotherapy can still benefit advanced gastrointestinal cancer patients with weak physical condition. Hemoglobin level, pain and gastrointestinal function are independent prognostic factors for these patients.
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Objective:To analyze the mediating role of self-esteem and control sources in readmission frequency and self-perceived burden of elderly patients with chronic heart failure(CHF).Methods:A total of 346 cases of elderly patients with CHF were included, using self-perceived burden scale(SPBS), self-esteem scale(SES) and multidimensional health locus of control scale(MHLC) to investigate.SPSS 20.0 software was employed to coduct Pearson and Spearman correlation analysis and multiple linear stepwise regression to construct the structural equation model.Process 2.13.2 plug-in was used to test the intermediate effect of Bootstrap.AMOS 23.0 was used for structural equation model and path analysis verification.Results:(1) The readmission frequency during the recent years of the elderly patients with CHF was 0-8, and M( P25, P75) was 1(1, 3). The mean score of self-esteem scale was (29.25±3.67), and the score of internal control in psychological control source was (22.67±3.85). The score of influential others was (26.45±3.38). The opportunity score was (19.84±3.82). The mean SPBS score was (22.19±9.49). (2) SPBS total score was significantly negatively correlated with self-esteem ( r=-0.359, P<0.01), positively correlated with opportunity control source ( r=0.169, P<0.01). Self-esteem was positively correlated with internal control( r=0.237, P<0.01), control of influential others( r=0.225, P<0.01). The readmission frequencies of CHF were significantly negatively correlated with self-esteem( r=-0.119, P<0.05) and internal control( r=-0.173, P<0.01), positively correlated with SPBS( r=0.219, P<0.01). (3) Multiple regression and structural equation model results showed that readmission, self-esteem and psychological control sources could account for 18.0% of the total variables of self-perceived burden.The relationship between readmission and self-perceived burden was mediated by self-esteem and locus of control, accounting for 20.00% of the total effect. Conclusion:Self-esteem and control sources are partially mediating the effect between readmission and self-perceived burden.By nursing intervention to improve the self-esteem level, positive coping strategies of internal control of elderly patients with CHF, the burden of self-perception may possibly be alleviated.
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Objective@#To explore the clinical value of low molecular weight heparin(LMWH) plus low dose aspirin(LDA) in preventing twin pregnancy with preeclampsia high risk factors.@*Methods@#From January 2013 to December 2017, the twin pregnancy cases with preeclampsia high risk factors who were diagnosed in Shanxi Rongjun Hospital were randomly divided into two groups according to the order of the treatment.The observation group(n=53) used LMWH plus LDA to prevent preeclampsia, while the control group(n=53) used LDA alone.The incidence of preeclampsia and pregnancy outcome were compared between the two groups.@*Results@#The incidence of severe preeclampsia in the observation group(5.7%) was lower than that in the control group(18.9%)(χ2=4.296, P<0.05), and there was statistically significant difference in the delivery time between the two groups(χ2=7.993, P<0.05). While the incidence of preeclampsia, placental abruption, postpartum hemorrhage and FGR between the two groups had no statistically significant differences (all P>0.05). The proportion of NICU transferred fetus in the observation group(18.3%) was lower than that in the control group(30.7%)(χ2=4.289, P<0.05). There were no statistically significant differences in perinatal mortality and neonatal asphyxia(all P>0.05).@*Conclusion@#Compared with using the LDA alone, LMWH plus LDA prevention can effectively reduce the incidence of severe preeclampsia in twin pregnancies; at the same time, it also can delay the delivery time and reduce the rate of NICU transferred.
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Objective To explore the clinical value of low molecular weight heparin(LMWH) plus low dose aspirin(LDA) in preventing twin pregnancy with preeclampsia high risk factors.Methods From January 2013 to December 2017,the twin pregnancy cases with preeclampsia high risk factors who were diagnosed in Shanxi Rongjun Hospital were randomly divided into two groups according to the order of the treatment .The observation group(n=53) used LMWH plus LDA to prevent preeclampsia ,while the control group ( n=53) used LDA alone.The incidence of preeclampsia and pregnancy outcome were compared between the two groups .Results The incidence of severe preeclampsia in the observation group(5.7％) was lower than that in the control group (18.9％)(χ2 =4.296,P<0.05),and there was statistically significant difference in the delivery time between the two groups (χ2 =7.993,P<0.05).While the incidence of preeclampsia ,placental abruption,postpartum hemorrhage and FGR between the two groups had no statistically significant differences (all P >0.05).The proportion of NICU transferred fetus in the observation group(18.3％) was lower than that in the control group (30.7％)(χ2 =4.289,P<0.05).There were no statistically significant differences in perinatal mortality and neonatal asphyxia ( all P >0.05 ).Conclusion Compared with using the LDA alone , LMWH plus LDA prevention can effectively reduce the incidence of severe preeclampsia in twin pregnancies;at the same time,it also can delay the delivery time and reduce the rate of NICU transferred.
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As the key features of tumor, metastasis has multiple mechanisms and could cause poor survival. Accumulated evidences indicate that platelet plays an important role in tumor metastasis. Platelet count had become a significant indicator for predicting tumor prognosis,and antiplatelet therapy is an effective way for tumor treatment. Here, the recent advancements of the relationship between platelets and tumor metastasis are reviewed.
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Objective To propose a method to calculate sample size for survival analysis in single-arm trials.Methods Through theoretical formula derivation,we provided sample size estimation method for survival analysis in single-arm trials.Monte-Carlo simulations using STATA software were conducted to obtain the empirical power,so as to verify the accuracy of the estimated sample size.Results Simulation results showed that,when α =0.025 and α =0.01,the power of the sample size calculated by the formula is in accordance with the predetermined power.Conclusions The formula of sample size estimation we proposed could achieve the predetermined power for survival analysis in single-arm trials.Findings of this study provide reliable basis for sample size estimation of early stage antineoplastic drug clinical studies.
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Objective To investigate the applicability of autoregressive integrated moving average (ARIMA) model in predicting healthcare-associated infection(HAI) in children.Methods The ARIMA model was constructed according to the incidence of HAI in a hospital from January 2011 to December 2014.With the use of information criterion,optimal model was determined;HAI data in 2015 was as test samples,the feasibility of the model was evaluated.Results ARIMA (0,1,1) was the optimal prediction model for HAI rate,the Akaike Information Criterion (AIC) and Bayesian Information Criterion(BIC) of the ARIMA (0,1,1) were 66.61 and 70.76,respectively.The Ljung-Box statistics value Q =14.14 was not significantly different (P =0.658),suggesting a white noise sequence of residuals with a good model fitting.The mean absolute percent error(MAPE) between actual and fitting value of HAI was 22.4,the actual values were within the 95％ confidence interval.Conclusion ARIMA model fits the time series data,and can achieve satisfactory effect on predicting the incidence of HAI in hospitalized children.
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<p><b>BACKGROUND</b>Insulin resistance (IR) plays an important pathophysiological role in the development of diabetes, dyslipidemia, hypertension, and cardiovascular disease. Moreover, IR can occur even in non-obese people without diabetes. However, direct detection of IR is complicated. In order to find a simple surrogate marker of IR early in non-obese people, we investigate the association of commonly-used biochemical markers (liver enzymes and lipid profiles) with IR in urban middle-aged and older non-obese Chinese without diabetes.</p><p><b>METHODS</b>This cross-sectional study included 1 987 subjects (1 473 women). Fasting blood samples were collected for measurement of glucose, insulin, liver enzymes, lipid profiles and creatinine. Subjects whose homeostasis model of assessment-IR (HOMA-IR) index values exceeded the 75th percentile (2.67 for women and 2.48 for men) of the population were considered to have IR. The area under the receiver operating characteristic curve (ROC) was used to compare the power of potential markers in identifying IR.</p><p><b>RESULTS</b>Triglycerides (TG) and ratio of TG to high-density lipoprotein cholesterol (TG/HDL-C) discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic (ROC) curves (AUC) values were 0.770 (95% confidence interval 0.733-0.807) and 0.772 (0.736-0.809), respectively, for women and 0.754 (0.664-0.844) and 0.756 (0.672-0.840), respectively, for men. To identify IR, the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L (sensitivity 74.3%, specificity 71.0%) and 0.873 (sensitivity 70.1%, specificity 73.4%), respectively, for women, and 1.275 mmol/L (sensitivity 66.7%, specificity 74.4%) and 0.812 (sensitivity 75.8%, specificity 69.2%), respectively, for men.</p><p><b>CONCLUSION</b>TG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.</p>
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Aged , Female , Humans , Male , Middle Aged , Alanine Transaminase , Blood , Aspartate Aminotransferases , Blood , Cholesterol, HDL , Blood , Cross-Sectional Studies , Diabetes Mellitus , Blood , Insulin Resistance , Physiology , Liver , Triglycerides , BloodABSTRACT
Objecfive To observe the effects of combined acupuncture and point injection in the treatment of diabetic ophthalmoplegia patients.Methods 40 patients with diabetic ophthalmoplegia were randomly recruited into a control group and a treatment group,with 20 patients in each group.The control group was treated with acupuncture,and the treatment group was additionally treated with point injection.Therapeutic effects were observed after the treatment.Results Effective rate was 85% and 55%in the treatment group and the control group respectively,showing significant difference(P=0.0384<0.05).Conclusion Acupuncture combined with point injection is effective in treating patients with diabetic ophthalmoplegia.
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Objective To explore an effective therapy for post-operative urine retention. Methods A total of 264cases were randomly recruited into a intervention group (135 cases) and a control group (129 cases). The intervention group was treated with acupuncture and acupoints massage, and the control group was treated with conventional therapy. Results The total effective rate of was 97.04% and 77.52% in the intervention group and the control group respectively, showing significant difference (χ2=28.657, P＜0.01); The average time for the first time urination of two groups was 24.38min and 35.41 min respectively, also showing significant difference (t= -14.552, P＜0.01). Conclusion Acupuncture and acupoints massage was an effective way for the treatment of post-operative urinary retention.
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Objective To observe clinical effect of treating blepharospasm with acupuncture. Methods 27 patients with blepharospasm were randomly recruited into a control group and a treatment group. The control group was treated with western medicine, and the treatment group was treated with acupuncture. The clinical effects of both groups were observed. Results Total effective rate in the treatment group and the control group was 85.7% and 69.2%, respectively. There was a significant dieffference between the two groups (P<0.05) . Conclusion The treatment of acupuncture on blepharospasm is better than western medicine.
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OBJECTIVE To compare the air sterilization effect of in operating room used by different air sterilization methods.METHODS Four types sterilization methods were used to operating room air.Then sampling monitoring and evaluation were done.RESULTS The qualification rate of air sterilization were 79.17%,62.79%,79.63%,97.22% in peroxyacetic acid fumigating,simple ultraviolet radiation,peroxyacetic acid fumigating combined with simple ultraviolet radiation,ultraviolet light circulation wind air sterilization machine,respectively.The sterilization effect of ultraviolet light circulation wind was better than the others.CONCLUSIONS Ultraviolet light circulation wind air sterilization machine can be used to air sterilization in non-laminar air flow purify operating room.
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Objective To observe clinical effect of treating ophthalmoplegia with acupuncture combined with point injection. Methods 25 cases patients with ophthalmoplegia were randomly recurited into a control group and a treatment group. The control group was treated with western medicine and the treatment group was treated with acupuncture combined with point injection. The clinical effect of both groups was observed after treatment. Results The clinical effect in the treatment group was significantly higher than that of the control group (P<0.05) . Conclusion The treatment of ophthalmoplegia with acupuncture combined with point injection has a good effect.
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Objective: To study the curative effects of Rupixiao Grains on mammary hyperplasia rats and provide the bisis for the wider use. Methods: The model of mammary hyperplasia were established with estrogen and progestogen, the changes of nipple appearance and pathological tissue of mammary gland on morphologic change were observed. The E2, P and PRL of serum were determined. Results: The treatment groups of high and middle dose of Rupixiao Grains can siginifi cantly reduce the diameter and height of nipple in rat mammary gland hyperplasia models(P
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0.05) ;incidence of aleucocytosis was 43.3% vs.27.5%(P
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Objective To discuss CT techniques and features of gastric antrum canser.Methods The findings of gastric antrum cancer were analysed in 38 cases with the review of literature.Results The CT findings of gastric antrum cancer were thickening of gastric wall,formation of soft tissue tumour,narrowing of gastric antrum lacuna and in combination with ulcer.The duodenum and around stomach could be invaded by tumor.Conclusion The full view of gastric antrum carcinoma and its relation with adjacent organs can be distinctively showed by CT.
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OBJECTIVE:To observe the analgesia effects of transdermal fentanyl in the treatment of pharynx oralis pain caused by radiotherapy.METHODS:30patients with pate squamous carcinoma and serious membrana mucosa ulcerate and pain after a whole range radiotherapy,who were treated with3to5patches2.5mg(25?g/h)of transdermal fentanyl every9～15days if their VAS scores were found to be more than6scores.The analgesia effect,life quality and the adverse reaction were evaluated respectively with VAS,Digit-scale and east American carcinoma cooperation group toxicity criteria.RESULTS:The average VAS scores has been lowered from7.86?1.18before the treatment to2.24?1.31on10th day of the treatment(P