Research progress on circular RNA in fundus oculi proliferative diseases / 中华实验眼科杂志

Fundus oculi proliferative diseases, such as choroidal neovascularization, diabetic retinopathy, and proliferative vitreoretinopathy, are characterized by cell proliferation and neovascularization.It can lead to damage to the ocular structure and visual acuity.Circular RNA (CircRNA) is a non-coding endogenous RNA, which has been confirmed to be involved in the pathophysiological process of many ophthalmic diseases by recent studies.Thus, circRNA may become a promising target of fundus oculi proliferative diseases.This review concluded the physiological function of circRNA and its role in the physiological and pathological process of diabetic retinopathy, proliferative vitreoretinopathy and glaucoma-related glia proliferation.

Neurophilic herpesvirus: a powerful tool for neuroscience research / 生物工程学报

Viruses are powerful tools for the study of modern neurosciences. Most of the research on the connection and function of neurons were done by using recombinant viruses, among which neurotropic herpesvirus is one of the most important tools. With the continuous development of genetic engineering and molecular biology techniques, several recombinant neurophilic herpesviruses have been engineered into different viral tools for neuroscience research. This review describes and discusses several common and widely used neurophilic herpesviruses as nerve conduction tracers, viral vectors for neurological diseases, and lytic viruses for neuro-oncology applications, which provides a reference for further exploring the function of neurophilic herpesviruses.

Prognostic value of lymphocyte subsets in gastric cancer with different tumor infiltration patterns / 中华普通外科杂志

Objective:To probe into the potential prognostic value of lymphocyte subsets in gastric cancer.Methods:This study included patients who underwent radical gastrectomy for gastric cancer from Aug 2014 to Dec 2016. The immunological differences was analyzed in different infiltration patterns. The overall survival of patients was analyzed by Kaplan-Meier method and Log-rank test. COX regression was performed to assess independent prognostic factors of the patients, and finally constructed nomogram.Results:The median number of peripheral CD4 and CD19 cells in infiltration pattern c was 750 (94-2 504) cells/μl and 186 (17-820) cells/μl; the median number of peripheral CD4 and CD19 cells in infiltration pattern a was 802 (203-2 071) cells/μl and 213 (5-948) cells/μl, the number of peripheral CD4,CD19 cells in infiltration pattern c was lower than that in infiltration pattern a, with statistically significant differences (CD4: Z=-3.061, P=0.002; CD19: Z=-2.016 , P=0.044). CD19 lymphocytes ( P=0.023) were associated with infiltration pattern a, CD8 lymphocytes ( P=0.027) were associated with infiltration pattern b, and CD4 lymphocytes ( P=0.026) were independent risk factors associated with the prognosis of infiltration pattern c. A nomogram can be constructed to evaluate the prognosis of patients. Conclusion:There are differences in the number of peripheral lymphocyte subsets in patients with different INF types. A nomogram can be constructed from lymphocyte subsets and clinicopathological features to assess patient prognosis.

The expression and clinical significance of microRNA-574-3p in colon cancer / 中国医师杂志

Objective:To study the expression and clinical significance of microRNA-574-3p (miR-574-3p) in colon cancer.Methods:A total of 106 colon cancer patients who were admitted to the First Hospital of Qinhuangdao and Shijiazhuang Hospital of Traditional Chinese Medicine from June 2012 to June 2015 were selected as the research objects. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression level of miR-574-3p in colon cancer tissues and normal adjacent tissues. The relationship between the expression of miR-574-3p and the clinicopathological characteristics and prognosis of patients with colon cancer was analyzed. Immunohistochemical staining was used to detect the relationship between the expression of miR-574-3p and the expression of CyclinA2 or E-cadherin.Results:Compared with normal tissues adjacent to cancer, the expression level of miR-574-3p in 106 cases of colon cancer was significantly lower ( P<0.01). The decreased expression of miR-574-3p was related to tumor diameter, Dukes stage, histological grade and lymph node metastasis (all P<0.05), but not to age and tumor location (all P>0.05). The patients with low expression of miR-574-3p, high Dukes stage and histological grade, and lymph node metastasis had poor survival (all P<0.05). The 5-year overall survival rate of patients with decreased miR-574-3p expression in cancer tissue was significantly lower than that of patients without decreased miR-574-3p expression ( P=0.007 6). Compared with patients with no decreased miR-574-3p expression, patients with decreased miR-574-3p expression had higher CyclinA2 protein integrated optical density (IOD) value and lower E-cadherin protein IOD value in colon cancer tissues (all P<0.05). Conclusions:The decreased expression of miR-574-3p is related to the poor prognosis of colon cancer patients, which may affect tumor recurrence and metastasis by regulating the expression of CyclinA2 and E-cadherin proteins.

Screw-plate fixation versus non-cannulated screw fixation for Lisfranc ligament injury: a 3-D finite element analysis / 中华创伤骨科杂志

Objective:To compare biomechanical stabilities between screw-plate fixation and non-cannulated screw fixation for Lisfranc ligament injury by a 3-D finite element analysis.Methods:A 3-D model of a healthy foot was developed from computed tomography images. The 1st and the 2nd dorsal tarsometatarsal ligaments and Lisfranc ligament were cut in the 3-D model of a healthy foot to establish a Lisfranc ligament injury model, in which screw-plate fixation (with 2 locking plates and 8 standard screws and one non-cannulated screw) and non-cannulated screw fixation (with 3 non-cannulated screws) for Lisfranc ligament injury were simulated respectively. Finite element analyses were carried out by Abaqus 6.14 software after loads were added in the 3-D models of screw-plate fixation and non-cannulated screw fixation for Lisfranc ligament injury. The overall stress-strain nephogram, the stress distribution and displacement of the foot bone, and the stress distribution on the internal fixation system were compared between the 2 kinds of models.Results:Under the same load, the stress of the whole screw-plate fixation was concentrated on the fixators, and the stress of the non-cannulated screws was also greater than that of the bones. In both models, the strain of the whole foot led to arch collapse, especially in the medial column. The maximum stress on the screw holes in the medial and middle columns in the screw-plate fixation model was 39.91 MPa, smaller than that in the non-cannulated screw fixation model (53.13 MPa). The relative displacement of the first metatarsal joint in the screw-plate fixation model was 8.515 × 10 -1 mm, much greater than that in the non-cannulated screw fixation model (3.893 × 10 -1 mm). Stress concentration was observed in both models. The stress of the screw-plate system was concentrated on the fibular side of the middle section of the plate used to fix the first tarsometatarsal joint, decreasing towards both ends. The maximum stress of the non-cannulated screws was located in the middle of the medial column screw for fixation of the first tarsometatarsal joint, significantly greater than those of the both ends. The maximum stress of the screw-plate system was 239.5 MPa, smaller than that of the non-cannulated screws (256.8 MPa). Conclusions:Non-cannulated screw fixation demonstrates a greater biomechanical stability for Lisfranc ligament injury than screw-plate fixation. However, the former may have a higher risk of screw breakage because it bears a greater stress.

Application of double-line mixed teaching in the teaching of medical students in the practice of department of surgical oncology / 中华医学教育探索杂志

Objective:To construct a double-line mixed teaching mode and to explore its application effect on the practice teaching of medical students in the department of surgical oncology.Methods:A total of 80 clinical medicine students were selected and randomly divided into a routine group and a research group, with 40 students in each group. The routine group implemented regular teaching, and the research group developed "double-line mixed teaching" mode. After teaching, the students' theoretical and practical skills assessment results, changes in medical students' abilities and their satisfaction with teaching were compared between the two groups. SPSS 19.0 was used for t test and chi-square test. Results:The theoretical and practical skill assessment scores of the research group were significantly higher than those of the routine group [(91.59±3.65) score vs. (84.67±4.34) scores, (86.05±4.16) scores vs. (74.73± 4.69) scores] ( P<0.05). The scores of medical humanistic spirit, clinical thinking ability, scientific research thinking ability, critical thinking and innovation ability of the two groups after teaching were all higher than those before teaching, and the above-mentioned ability scores of the research group were all higher than those of the routine group after teaching ( P<0.05). The satisfaction rates of the students in the research group regarding teaching content and form, improving self-study ability, strengthening understanding and mastering of knowledge, deepening practical experience, and improving collaboration ability were all higher than those of students in the routine group (87.50% vs. 67.50%; 82.50% vs. 60.00%; 90.00% vs. 67.50%; 92.50% vs. 75.00%; 95.00% vs. 77.50%), and the differences were statistically significant ( P<0.05). Conclusion:Constructing double-line mixed teaching mode in the practice teaching of medical students in the department of surgical oncology can improve the performance of theoretical and practical skills assessment, as well as improve the various abilities of medical students, and can obtain high satisfaction with the teaching mode.

Comparison of the reliability and validity between the Chinese version of SANDE and OSDI dry eye questionnaires / 中华实验眼科杂志

Objective:To assess the applicability of the Chinese version of the symptom assessment in dry eye (SANDE) questionnaire refer to the ocular surface disease index (OSDI) questionnaire.Methods:A cross-sectional study was conducted.Three hundred and twenty-three students from a senior high school in Hongkou District in Shanghai were enrolled in June 2020.The Chinese version of the SANDE and the OSDI questionnaires were answered by the students to assess the dry eye symptom and were collected on-site.Scores of the two questionnaires were calculated.According to the OSDI score, the students were divided into the normal control group ( n=87), mild dry eye group ( n=82), moderate dry eye group ( n=87) and severe dry eye group ( n=67). Cronbach α was obtained to evaluate the internal consistency.Kruskal-Wallis test was used to analyze the difference in SANDE scores among dry eye groups with different severities and evaluate the discriminative validity.Correlation between the total scores of the two questionnaires was analyzed by using Spearman rank correlation analysis to evaluate the criterion validity.Factor analysis was used to evaluate the construct validity.Receiver operating characteristic curve (ROC) was drawn to obtain the area under the ROC curve (AUC) and cut-off point to evaluate the diagnostic threshold for dry eye.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shanghai General Hospital (No.2020KY026). Written informed consent was obtained from guardians of each subject. Results:The Cronbach α of the SANDE and OSDI questionnaires were 0.856 and 0.829, respectively.SANDE score of the four groups classified according to the OSDI score was 7.0 (2.5, 16.9) for the normal control group, 17.0 (8.4, 31.0) for the mild dry eye group, 29.2 (14.6, 49.4) for the moderate dry eye group and 49.1 (24.4, 60.7) for the severe dry eye group, respectively, which was increased in turn.There was a statistically significant overall difference in the SANDE score among the four groups ( H=113.213, P<0.001), and statistically significant pairuise differences were found (all at P<0.05). The SANDE score was moderately positively associated with the OSDI score ( rs=0.615, P<0.001). The factor analysis revealed that for the SANDE questionnaire, factor loadings of its two items on the common factors were higher than 0.5, among which the frequency of dry eye symptoms was 0.936, and the severity of dry eye symptoms was 0.936.The AUC of the SANDE questionnaire was 0.815 ( P<0.001, 95% CI: 0.770-0.860). When using 23 as the diagnostic threshold for dry eye, the sensitivity and specificity of the SANDE questionnaire were 60.59% and 88.51%, respectively. Conclusions:The Chinese version of the SANDE questionnaire shows good reliability, validity, discrimination ability and slightly poor sensitivity in detecting dry eye.As a simple assessment questionnaire, it is applicable to the Chinese population and is of good clinical application value.

Clinical factors associated with composition of lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia / 医学前沿

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R2 = 0.033; P = 0.018), followed by acute kidney injury (AKI; R2 = 0.032; P = 0.011) and plasma MIP-1β level (R2 = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

Research of the core items of Physical Literacy Guidelines for Children and Adolescents / 中国学校卫生

Objective@#Physical literacy is the breakthrough point and fundamental goal to achieve the integration of sports and education, sports and public health and expand the function of physical education. Studying the children and adolescents physical literacy is a common responsibility for children and adolescents health, sports and health education workers. This article was based on the latest research evidence and expert opinions in China, aiming to develop the core items of physical literacy guidelines for Chinese children and adolescents.@*Methods@#This article systematically combed the dimensions and index system of children and adolescents physical literacy through systematic literature review. After five rounds of Delphi methods, the core items were extracted.@*Results@#The core items included four interrelated dimensions of body, emotion, behavior, and cognition, which were specifically composed of four components: physical ability, emotional experience, physical activity related behaviors, and knowledge understanding and application ability.@*Conclusion@#Children and adolescents are the key periods, sensitive periods, and window periods to cultivate physical literacy. The core items can provide framework recommendations for further refining guidelines. More empirical studies should be carried out in the future, in order to accumulate enough evidences and further to improve Physical Literacy guidelines, better to guide physical literacy promotion.

Effect of preoperative serum alanine aminotransferase and asparagine aminotransferase ratio on prognosis of patients with gastric cancer / 中华胃肠外科杂志

Objective@#To study the relationship of liver function index alanine aminotransferase and aspartate aminotransferase ratio (LSR) with clinicopathological factors in patients with gastric cancer and its clinical significance in predicting the survival of patients.@*Methods@#A retrospective case-control study was used. Retrospective analysis was conducted on 891 patients with advanced gastric cancer who underwent gastric cancer surgery at the Gastrointestinal Surgery Department of Harbin Medical University Cancer Hospital from January 2007 to December 2010, having complete postoperative clinicopathological and follow-up data. Case inclusion criteria: (1) preoperative definite diagnosis of gastric cancer, residual gastric cancer and other gastric tumors were excluded; (2) no neoadjuvant therapy before surgery; (3) no other serious diseases such as acute coronary heart disease, cirrhosis, chronic renal failure, etc.; (4) radical gastrectomy was performed, palliative treatment or open laparotomy cases were excluded; (5) complete postoperative pathological data, complete follow-up information; (6) cause of death was associated with gastric cancer. Blood examination was performed during hospitalization. The best cut-off points of LSR, hemoglobin, lymph node metastasis rate, maximum diameter of tumors, alkaline phosphatase, glutamyl transpeptidase, total bilirubin and lactate dehydrogenase were obtained by using receiver operating characteristic curve(ROC). Patients were divided into two groups according to best LSR cut-off points. The relationship between LSR and clinicopathological factors was analyzed, and the overall survival rate of different LSR groups was compared. Relevant clinical factors and LSR were included in the univariate and multivariate survival analysis using the Cox method.@*Results@#The best cut-off point of LSR in ROC curve was 1.43, and 682 cases in LSR<1.43 group, 209 cases in LSR≥1.43 group. The best cut-off points of hemoglobin, lymph node metastasis rate, maximum diameter of tumors, alkaline phosphatase, glutamyl transpeptidase, total bilirubin and lactate dehydrogenase were 130.2 g/L, 18.0%, 4.75 cm, 68.1 U/L, 16.55 U/L, 5.58 μmol/L and 135.8 U/L, respectively. Between patients with LSR<1.43 and LSR≥1.43, age (χ2=4.412, P=0.036), depth of tumor invasion (χ2=64.306, P<0.001), histological type (χ2=8.026, P=0.005), alkaline phosphatase (χ2=8.217, P=0.004), glutamyl transpeptidase (χ2=33.207, P<0.001), total bilirubin (χ2=14.012, P<0.001) and lactate dehydrogenase (χ2=63.630, P<0.001) were significantly different. The 1-, 3- and 5-year survival rates of LSR<1.43 group and LSR≥1.43 group were 70.8%, 31.3%, 25.0% and 64.9%, 24.4%, 11.3% respectively, whose difference was significant (χ2=10.140, P=0.001). Univariate analysis showed that age, hemoglobin, TNM stage, depth of invasion, lymph node metastasis rate, lymph node metastasis, histological type, maximum diameter of tumors, glutamyl transferase, total bilirubin and LSR were associated with overall survival of gastric cancer (all P<0.05). Multivariate analysis showed that tumor TNM stage (HR=1.605, 95%CI: 1.332 to 1.936, P<0.001), tumor invasion depth (HR=1.299, 95%CI: 1.168 to 1.445, P<0.001), lymph node metastasis rate (HR=2.400, 95%CI:1.873 to 3.076, P<0.001), lymph node metastasis (HR=1.263, 95%CI: 1.106 to 1.478, P=0.007), maximum tumor diameter (HR=1.375, 95%CI: 1.134 to 1.669, P=0.001), and LSR (HR=1.427, 95%CI: 1.190 to 1.711, P<0.001) were independent risk factors for the prognosis of patients with gastric cancer.@*Conclusions@#LSR is an independent risk factor for the prognosis of gastric cancer patients, and the detection is simple and easy. It is a potential marker for the prognosis of gastric cancer. Therefore, in the preoperative comprehensive management stage, it should be possible to restore and improve the liver function in order to obtain a better prognosis of gastric cancer and prolong the survival time of patients.

Prognostic evaluation of patients with TNM stage Ⅰ to Ⅲ gastric cancer by platelet-lymphocyte ratio and neutrophil-lymphocyte ratio / 中华消化杂志

Objective:To compare the ability of platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) in evaluating the prognosis of patients with TNM stageⅠto Ⅲ gastric cancer.Methods:From May 2001 to December 2013, the clinicopathological data of 645 patients with gastric cancer treated at Harbin Medical University Cancer Hospital were retrospectively analyzed. Chi-square test was used to analyze the differences between NLR, and PLR and clinicopathological characteristics of patients. Kaplan-Meier method and log-rank test were performed to compare the overall survival of patients. Cox proportional hazards regression model was performed to analyze the prognosis of gastric cancer patients. The ability of NLR and PLR to evaluate the prognosis of gastric cancer was compared by receiver operating characteristic curve.Results:The cutoff values of PLR and NLR were 141.50 and 1.94, respectively. PLR was associated with gender, resection method, maximum diameter of tumor, whether chemotherapy, T-stage, N-stage, TNM stage, tumor location, white blood cell, hemoglobin, albumin, and whether total gastrectomy ( χ2=9.224, 10.577, 28.825, 6.831, 29.059, 28.637, 30.748, 18.023, 24.320, 77.274, 9.021 and 10.745, all P<0.05). NLR were associated with resection method, maximum diameter of tumor, T-stage, N-stage and TNM stage, white blood cell, hemoglobin and albumin ( χ2=14.563, 12.092, 22.697, 44.735, 34.151, 7.949, 9.611 and 7.498, all P<0.05). The results of multivariate analysis showed that resection method, whether chemotherapy, T-stage, N-stage, PLR and whether total gastrectomy were all independent risk factors for gastric cancer patients ( χ2=23.653, 22.023, 16.697, 24.038, 4.110 and 22.364, all P<0.05). The five-year cumulative survival rate of the patients with PLR<141.50 was higher than that of patients with PLR≥141.50 (55.4% vs. 30.5%), and the difference was statistically significant ( χ2=47.968, P<0.01). The AUC value of PLR in prognostic evaluation of gastric cancer was 0.629, which was higher than that of NLR (0.596, P<0.01). Conclusion:PLR is better than NLR in the prognostic evaluation of gastric cancer patients.

Correlation between preoperative serum alanine transaminase and the prognosis of postoperative gastric cancer patients / 中华普通外科杂志

Objective To study the relationship between preoperative serum ALT and clinicopathological factors in patients with gastric cancer after radical gastrectomy.Methods At the Department of Gastrointestinal Surgery,Tumor Hospital of Harbin Medical University from Jan 2008 to Dec 2010,491 patients were grouped according to ROC curve cut-off point of serum ALT.The relationship between ALT and clinical factors was analyzed,and single-factor and multi-factor survival analysis was performed.Results There were 201 patients with ALT ≤ 20.05 U/L,and 290 patients with ALT ＞ 20.05 U/L Serum ALT was associated with age (x2 =11.231,P ＜ 0.001),depth of tumor invasion (x2 =23.178,P＜0.001),GGT(x2 =19.190,P＜0.001) and AST(x2 =30.771,P＜0.001).The 1-,3-,and 5-year survival rates of patients with ALT ≤ 20.05U/L and ALT ＞ 20.05U/L were 83.5％,51.4％,42.1％ and 66.2％,27.4％,15.7％.There was significant difference between the two groups (x2 =41.711,P＜0.001).Muhivariate analysis showed that tumor TNM stage(HR =1.882,95％ CI:1.468-2.413,P ＜0.001),tumor infiltration depth (HR =1.161,95％ CI:1.020-1.322,P =0.024),lymph node metastasis (HR =1.177,95％ CI:1.042-1.329,P =0.009),Hb (HR =0.726,95％ CI:0.579-0.909,P =0.005),neutrophil to lymphocyte rate(HR =1.275,95％ CI:1.002-1.623,P =0.048) and ALT(HR =2.191,95％ CI:1.754-2.738,P ＜ 0.001) were independent risk factors for the prognosis.Conclusions Serum ALT is an independent risk factor for the prognosis of gastric cancer patients after radical gastrectomy.

Relationship between body mass index and clinicopathological characteristics and prognosis of gastric cancer patients / 中华肿瘤杂志

Objective@#To investigate the relationship between body mass index (BMI) and clinicopathological characteristics and prognosis of gastric cancer patients.@*Methods@#The clinical data of 788 patients with advanced gastric cancer were retrospectively analyzed. According to WHO weight standard, BMI<18.5 kg/m2 was the low weight group, BMI 18.5~< 25.0 kg/m2 was the normal weight group, BMI ≥ 25.0 kg/m2 was the overweight group. The low weight group included 127 cases, the normal weight group included 540 cases and the overweight group included 121 cases. The relationship between different BMI groups and clinicopathological characteristics of patients was analyzed. Cox multivariate regression model was used to analyze the independent factor of the prognosis of patients.@*Results@#The average BMI of 788 patients was 21.70 kg/m2. The patients′ BMI was significantly correlated with depth of invasion, maximum diameter of tumors, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) (all P<0.05). BMI was marginally correlated with gender, age, smoking, alcohol consumption, TNM stage, lymph node metastasis and histological type (all P>0.05). Furthermore, BMI was significantly correlated with prealbumin, prognostic nutritional index, total protein, albumin and hemoglobin levels (all P<0.05). BMI was also significantly correlated with intraoperative bleeding volume, operation time, number of lymph node resection, number of lymph node metastasis and lymph node metastatic ratio (all P<0.05). The median survival time of the entire group was 35.3 months. The median survival time of patients in low weight group, normal weight group, and overweight group was 21.0 months, 26.3 months, and 31.2 months, respectively, the differences were statistically significant (P<0.001). Cox multivariate analysis showed that TNM stage, depth of tumor invasion, lymph node metastasis, PLR and BMI were independent risk factors of the prognosis of patients with gastric cancer (all P<0.05).@*Conclusions@#BMI is associated with the nutritional status, intraoperative blood loss, operative time, and lymph node metastatic ratio of patients with gastric cancer. BMI is an independent risk factor of the prognosis of patients with gastric cancer. The overall survival time of patients with low body weight is shorter than those of normal weight and overweight patients.

The prognostic value of serum albumin and hemoglobin in patients with proximal gastric cancer / 中华普通外科杂志

Objective To evaluate serum albumin (ALB) combined with hemoglobin (Hb) (ALB-Hb) in the prediction of prognosis of patients with proximal gastric cancer.Methods Clinial data of 311 patients with stage Ⅰ-Ⅲ proximal gastric cancer who underwent radical surgery were retrospectively analyzed in Harbin Medical University Cancer Hospital from Sep 2001 to Nov 2014.The preoperative ALB-Hb was calculated as following:patients with both elevated serum albumin (≥40.25 g/L) and hemoglobin (≥120 in male or ≥110 g/L infemale) were given a score of 0,and patients with only one or none were given a score of 1 or2,respectively.The ALB-HB scores of 0 points had 175 cases (56.2％),1 point had 87 cases (28.0％),and 2 points had 49 cases (15.8％).The optimal cut-off value of serum albumin,platelet count and maximum tumor diameter were defined by ROC curve;Pearson correlation was used to evaluate the correlation coefficient between serum albumin and HB;Survival analysis was analyzed by Kaplan-Meier method.The prognostic factors for patients with proximal gastric cancer was analyzed by COX proportional hazards model.The ROC curve was used to compare the prognostic value of serum albumin,hemoglobin,and ALB-Hb.Results Patients with ALB-Hb score of 2 were associated with age,serum platelet level,and maximum tumor diameter (all P ＜ 0.05).The median survival time was 41 months (3-134 months).233 cases (74.9％) died and 78 cases (25.1％) survived as of Jan 2018.There was a significant difference in overall survival (OS) among A1B-Hb scores of 0,1,and 2 (P =0.011).Univariate analysis demonstrated that platelet count,ALB-Hb score,maximum tumor diameter,and clinical stage were related to the prognosis of patients with proximal gastric cancer (all P ＜ 0.05).By multivariate analysis there were statistically significant differences in pathological parameters:ALB-Hb score (HR =1.249,95％ CI 1.047-1.489,P =0.013),maximum tumor diameter (HR =1.352,95％ CI 1.016-1.799,P=0.038) and TNM clinical stage (HR=1.667 95％ CI 1.266-2.194,P＜0.001) is an independent risk factor for prognosis.ALB-Hb score compared to serum albumin and hemoglobin alone,has a higher AUC value (P =0.019).Conclusions The preoperative ALB-Hb score is superior to serum albumin or hemoglobin alone in assessing the prognosis for patients with stage Ⅰ,Ⅱ,and Ⅲ proximal gastric cancer.

Effect of preoperative systemic immune inflammation index on the prognosis of postoperative gastric cancer patients / 中华普通外科杂志

Objective To study the relationship between preoperative systemic immune inflammatory index (SII) and the prognosis of postoperative patients. Methods A retrospective analysis was made on 1 509 patients with gastric cancer who underwent gastric cancer surgery at the Department of Gastrointestinal Surgery,Affiliated Tumor Hospital of Harbin Medical University from Jan 1991 to Dec 2012.The SII values [SII =(platelets x neutrophils) / lymphocytes] were calculated and grouped according to the SII mean.The relationship between SII and clinical factors was analyzed.Results Preoperative mean SII was 570.5,substratified into SII ＜ 570.5 group (871 cases),and SII ＞ 570.5 group (638 cases).There was a statistically significant difference between SII level and gender(x2 =4.239,P =0.040),tumor maximum diameter(x2 =31.852,P ＜ 0.001),total serum protein (x2 =7.962,P =0.005),Alb/Glob ratio(x2 =26.127,P＜ 0.001) and Hb(x2 =64.647,P＜ 0.001).The 1-,3-,and 5-year survival rates were 77.1％,42.4％,31.4％ and 68.9％,28.1％,19.8％,respectively(x2 =39.557,P ＜ 0.001).Multivariate analysis showed that tumor TNM stage (HR =1.592,95％ CI:1.401-1.809,P ＜ 0.001),infiltration depth(HR =1.256,95％ CI:1.145-1.377,P ＜ 0.001),lymph node metastasis(HR =1.177,95 ％ CI:1.042-1.329,P =0.009),tumor maximum diameter (HR =1.151,95 ％ CI:1.006-1.317,P =0.040),Hb(HR =0.832,95％ CI:0.737-0.940,P =0.003) and SII (HR =1.337,95％ CI:1.187-1.505,P ＜ 0.001) were independent risk factors for the prognosis of patients with gastric cancer.Conclusions SII is an independent risk factor for the prognosis of patients with gastric cancer.Preoperative SII ＞ 570.5 indicates poor prognosis.

Comparison of clinicopathological features and prognosis between adenocarcinoma of esophagogastric junction and adenocarcinoma of gastric antrum / 中华胃肠外科杂志

OBJECTIVE@#To compare the clinicopathological features and the prognosis between patients with adenocarcinoma of esophagogastric junction (AEG) and with adenocarcinoma of gastric antrum (AGA), and to investigate the prognostic factors of AEG and AGA.@*METHODS@#A retrospective cohort study was performed on clinicopathological data of 239 AEG patients (AEG group) and 313 AGA patients selected simultaneously (AGA group) undergoing operation at Harbin Medical University Cancer Hospital from January 2001 to December 2012.@*INCLUSION CRITERIA@#(1) receiving radical surgery (R0 resection); (2) AEG or AGA confirmed by pathological examination of postoperative tissue specimens; (3) without preoperative neoadjuvant radiotherapy or chemotherapy; (4) complete clinicopathological and follow-up data; (5) patients who died of non-tumor-related causes were excluded. Chi-square test and independent samples t-test were used to determine differences in clinicopathological factors between two groups. The overall survival (OS) of patients was compared by Kaplan-Meier method and Log-rank test. Multivariate prognosis analysis was performed using Cox proportional hazards regression model.@*RESULTS@#As compared to AGA group, AEG group had higher proportion of male [82.0%(196/239) vs. 65.2%(204/313),χ²=19.243,P0.05). The 5-year OS rate was 33.5% and 56.9% in AEG group and AGA group respectively and the median OS was 60.0(3.0-60.0) months and 33.6(3.0-60.0) months respectively; the difference was statistically significant (P<0.001). In AEG group, univariate analysis showed that differences of hemoglobin level (5-year OS rate: 24.0% for <130 g/L, 39.9% for ≥130 g/L, P=0.006), tumor diameter (5-year OS rate: 41.9% for <5 cm,28.8% for ≥5 cm, P=0.014), N stage (5-year OS rate: 42.2% for N0, 40.9% for N1, 31.7% for N2, 15.8% for N3a, 9.0% for N3b, P<0.001) and TNM stage (5-year OS rate: 56.2% for stage I, 38.5% for stage II, 28.3% for stage III,P=0.017) were statistically significant (all P<0.05); multivariate analysis revealed that the worse N stage was an independent risk factor of prognosis survival for AEG patients(HR=1.404,95%CI:1.164-1.693, P<0.001), and serum hemoglobin level ≥130 g/L was an independent protective factor of prognosis survival for AEG patients (HR=0.689,95%CI:0.501-0.946,P=0.021). In AGA group, univariate analysis showed that differences of serum albumin (5-year OS rate: 49.1% for <40 g/L, 61.1% for ≥ 40 g/L, P=0.021), tumor diameter (5-year OS rate: 74.2% for <5 cm, 39.9% for ≥ 5 cm, P<0.001), T stage (5-year OS rate: 98.3% for T1,83.3% for T2,50.0% for T3,36.8% for T4, P<0.001), N stage (5-year OS rate: 89.0% for N0, 62.3% for N1, 50.0% for N2, 33.9% for N3a, 10.3% for N3b, P<0.001) and TNM stage (5-year OS rate: 97.3% for stage I, 75.8% for stage II, 32.8% for stage III, P<0.001) were statistically significant (all P<0.05); multivariate analysis revealed that the worse T stage (HR=1.516,95%CI:1.060-2.167,P=0.023) and the worse N stage (HR=1.453,95%CI:1.209-1.747,P<0.001) were independent risk factors for prognosis of AGA patients.@*CONCLUSIONS@#As compared to AGA, AEG presents have poorer prognosis,and is easier to present with later pathological stage and larger tumor diameter. N stage and hemoglobin level are independent factors associated with the OS of AEG patients. T stage and N stage are independent factors associated with the OS of AGA patients.

Combining relative alpha variability and electroencephalogram reactivity to predict the prognosis of hypoxic?ischemic encephalopathy in adult patients / 中华内科杂志

Objective To evaluate the role of combining relative alpha variability and electroencephalogram (EEG) reactivity to predict the prognosis of hypoxic?ischemic encephalopathy(HIE) in adult patients. Methods A total of 28 adult patients with HIE admitted to general intensive care unit at Xiangya Hospital in Central South University were enrolled in this observational study from January2016 to April 2017. These patients with body temperature over 35℃after 72?hour admission could be continuously monitored at least 12 hours byEEG.At the same time,each patient was assessed for EEG reactivity.Then we analyzed the correlation between EEG reactivity, relative alpha variability and clinical prognosis. Results EEG reactivity was elicited in 15/28 patients, among whom 12 patients had a good outcome. While in the other 13 patients, EEG reactivity was not elicited, among whom only 3 patients had a good outcome. As to the results ofrelative alpha variability,11/13 patients with degree 3?4were of good prognosis; while only 3/15 patients with degree 1?2 were of good prognosis. Glasgow coma scale(GCS), EEG reactivity, and relative alpha variability were correlated with clinical outcome(χ2=5.073,9.073,-3.626, respectively,all P<0.05). The sensitivity of GCS, EEG reactivity,and relative alpha variability to predict the poor prognosis were 69.2%, 76.9%, 84.6%, respectively. The specificity were 73.3%, 80.0%, 73.3%, respectively. The consistency rates were 71.4%, 78.6%, 78.6%, respectively. The positive predictive values were 69.2%, 76.9%, 73.3%, respectively. The negative predictive values were 73.3%, 80.0%, 84.6%, respectively. More importantly, the accuracy of the relative alpha variability combined with EEG reactivity for the prediction of poor prognosis was much higher with the positive predictive value of 90.0%,the specificity of 93.3%,the sensitivity of 69.2%, the consistency rate of 82.1%,and the negative predictive values of 77.8%. Conclusions The combination of relative alpha variability and EEG reactivityis reliable to predict clinical outcome of patients with HIE.

The clinical value of prognostic nutritional index in gastric cancer patients with peritoneal metastasis / 中华普通外科杂志

Objective To evaluate the prognostic value of prognostic nutritional index (PNI) in gastric cancer patients with peritoneal metastasis.Methods 287 gastric cancer patients with peritoneal metastasis were enrolled from Jan 2010 to Dec 2016.Results Compared with PNI ＞ 45,patients in PNI≤45 group were elder [(59 ± 11) vs.(54 ± 11),t =3.734,P =0.000],lower albumin [(35 ± 4) g/L vs.(42 ± 4)g/L,t =15.988,P =0.003)],lower plasm hemoglobin concentration [(110 ± 22)g/L vs.(129 ±24) g/L,t =6.245,P =0.000),higher platelet count/lymphocyte count ratio [PLR,(210 ± 89) vs.(150 ± 66),t =6.547,P =0.000],higher neutrophil count/lymphocyte count ratio [NLR,(3.7 ± 2.9)vs.(2.4 ± 1.2),t =4.628,P =0.000],lower percentage of pallative gastrectomy (45.5％ to 58.5％,x2 =4.45,P =0.035).Logistic regression analysis showed that age ＞ 58-years,NLR ＞ 2.87,PLR ＞ 170,hemoglobin ≤ 130 g/L,local organ infiltration were risk factors leading to low-PNI (all P ＜ 0.05).The median survival time for all patients was 8.7 months.Univariate analysis revealed that,PNI ＞ 45,serum albumin ＞ 40 g/L,no ascites,lower-grade of peritoneal metastasis,pallative gastrectomy,postoperation chemotherapy were positively associated with better prognosis (all P ＜ 0.05).Multivariate analysis demonstarted that,PNI (HR =0.717,P =0.039).Grade of peritoneal metastasis (HR =1.206,P =0.044),pallative gastrectomy (HR =1.529,P =0.001) were independent prognostic risk factors for the patients with peritoneal metastasis.Conclusion PNI are both predictors of nutrition assessment and of prognosis for gastric cancer patients with peritoneal metastasis.

Comparison of clinicopathological features and prognosis analysis between carcinoma in the remnant stomach and gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare clinicopathological features and prognosis between patients with carcinoma in the remnant stomach (CRS) and with gastric cancer, and to investigate the prognostic factors in CRS patients.</p><p><b>METHODS</b>A retrospective cohort study was performed on clinicopathological data of 96 CRS patients (CRS group) and selected 440 patients with gastric cancer (GC group) treated at Harbin Medical University Cancer Hospital from January 1977 to December 2017.</p><p><b>INCLUSION CRITERIA</b>(1) undergoing gastrectomy; (2) diagnosed with CRS or gastric cancer through electronic gastroscopies and pathology; (3) without preoperative neoadjuvant radiotherapy or chemotherapy; (4) complete clinicopathological and follow-up data. The patients who died of other reasons or were lost during follow-up were excluded. Chi-square test and independent samples t-test were used to determine differences in clinicopathological factors between two groups. Survival analysis was conducted using the Kaplan-Meier method, and Log-rank test was used to compare survival difference between two groups. The prognosis of CRS patients was analyzed using Cox proportional hazards regression model.</p><p><b>RESULTS</b>As compared to GC group, CRS group had a higher proportion of female [30.2%(29/96) vs. 13.2%(58/ 440), χ=14.095, P=0.000], younger age [(56.4±10.1) years vs. (60.0±9.9) years, t=2.838, P=0.005], more distant metastasis and local organ infiltration [25.0%(24/96) vs. 16.1%(71/440), χ=4.246, P=0.039; 64.6% (62/96) vs. 24.5% (108/440), χ=58.331, P=0.000], lower prognostic nutritional index [(48.0±6.7) vs. (50.4±6.9), t=3.093, P=0.002], lower serum hemoglobin level [(115.0±24.7) g/L vs. (127.9±24.6) g/L, t=4.634, P=0.000], lower serum albumin level [(40.0±4.9) g/L vs. (41.2±5.0) g/L, t=2.038, P=0.042], and earlier occurrence of symptoms [(1.9±1.4) months vs. (3.7±3.2) months, t=5.431, P=0.000]. However, there were no statistically significant differences in TNM staging, postoperative hospital stay, and total hospitalization days between the two groups (all P>0.05). During follow-up, 24(25.0%) patients developed recurrence or distant metastasis and 68 (70.8%) patients died of tumor progression in CRS group, while 71(16.1%) patients developed recurrence or distant metastasis and 378(85.9%) patients died of tumor progression in GC group. The 5-year survival rate of CRS patients was 23.4%, which was higher than 15.0% of gastric cancer patients (P=0.032). Univariate analysis showed that the CRS patients with radical operation (P=0.000), earlier TNM stage (P=0.000), non-distant metastasis (P=0.022), serum hemoglobin level >130 g/L(P=0.013), and serum album level >40 g/L (P=0.042) had better prognosis. Multivariate analysis, enrolling above 5 factors, showed that TNM staging (HR=2.363, 95%CI: 1.478-3.776, P=0.000) and serum hemoglobin level >130 g/L(HR=0.449, 95%CI: 0.244-0.827, P=0.010) were independent factors influencing prognosis of CRS patients.</p><p><b>CONCLUSIONS</b>Although CRS patients have better prognosis than gastric cancer patients, but local organ invasion and distant metastasis occurs more readily. TNM staging and serum hemoglobin level are independent prognostic factors for CRS patients.</p>

The biological effects of magnetic fields on microvascular endothelial cells in the human brain / 中华物理医学与康复杂志

Objective To observe the biological effects of magnetic fields of different intensities on microvascular endothelial cells in the human brain (HBMECs).Methods HBMECs were cultured in vitro under normal conditions and randomly divided into a control group and several magnetic induction groups——26 mT,62.5 mT,110.7 mT and 215.6 mT at the center pole.Any changes to the cytomembranes were observed 72 h after planking using the lactate dehydrogenase (LDH) method.Superoxide dismutase and malondialdehyde methods were used to detect cellular oxidation due to the magnetic field.An inverted microscope was used to observe any changes in cell morphology,and flow cytometry was employed to detect cell apoptosis.Results Compared with the control group,the LDH value of the 215.6 mT group was significantly higher,but there were no significant differences in oxidative damage,apoptosis or morphology observed.Moreover,there were no significant differences between the controls and the 26 mT,62.5 mT and 110.7 mT groups in any of the above measurements.Conclusion Magnetic fields of different intensity have different biological effects on HBMECs.A 215.6 mT magnetic field influences their cell membranes but causes no oxidative damage,cell apoptosis or morphological changes.These observations and the mechanism need further exploration.