Comorbidity of hepatic cystic echinococcosis with HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma / 临床肝胆病杂志

Objective To investigate the comorbidity of hepatic cystic echinococcosis with HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma, and to lay a foundation for further research on the influence of hepatic cystic echinococcosis on HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma. Methods A retrospective analysis was performed for the data of 401 patients with hepatic cystic echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from 2003 to 2019, and the state of comorbidity of hepatic cystic echinococcosis with HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma was clarified. The patients with hepatic cystic echinococcosis and chronic HBV/HCV infection were selected as comorbidity group, and the patients with HBV/HCV infection alone were matched as control group. The chi-square test and the Fisher's exact test were used to analyze the state of viral infection and the disease composition of liver cirrhosis and hepatocellular carcinoma. Results Of all 401 patients, 38(9.5%) were included in the comorbidity group and 2(0.5%) had liver cirrhosis after HBV/HCV infection, while no patient had hepatocellular carcinoma after HBV/HCV infection. Among the patients with chronic hepatitis B virus infection in the comorbidity group, non-active HBsAg carriers accounted for 81%, HBeAg-positive chronic hepatitis B patients accounted for 9.5%, and HBeAg-negative chronic hepatitis B patients accounted for 9.5%; among the patients with hepatitis B virus infection in the control group, non-active HBsAg carriers accounted for 43%, HBeAg-positive chronic hepatitis B patients accounted for 33%, and HBeAg-negative chronic hepatitis B patients accounted for 19%, with a significant difference between the two groups ( P =0.033). There was a significant difference in the HBV RNA clearance rate of the patients with HCV infection between the comorbidity group and the control group ( χ 2 =4.447, P =0.035). In the comorbidity group, the patients with liver cirrhosis accounted for 5.2% and there were no patients with hepatocellular carcinoma, while in the control group, the patients with liver cirrhosis accounted for 18.4% and those with hepatocellular carcinoma accounted for 5.2%; the comorbidity group had significantly lower proportions than the control group ( P =0.048). Conclusion The proportion of liver cirrhosis patients with hepatic cystic echinococcosis and HBV/HCV infection is lower than that of liver cirrhosis patients with viral hepatitis alone, and there are no cases of hepatocellular carcinoma after HBV/HCV infection. Further multicenter studies are needed to investigate the influence of hepatic cystic echinococcosis on chronic HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma.

Correlation Study on Expression of PD-1 and PD-L1 in Non-small Cell Lung Cancer and Epidermal Growth Factor Receptor Mutations / 中国肺癌杂志

BACKGROUND@#The treatment mode of lung cancer is epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) as a first-line treatment for patients with EGFR mutant in non-small cell lung cancer (NSCLC). At the same time programmed death receptor 1 (PD-1) and its programmed death receptor ligand 1 (PD-L1) inhibitors therapy as the representative immune checkpoint inhibitors (ICIs) has a significant effect in the treatment of lung cancer. The aim of this study was to investigate the correlation between the expression of PD-1 and PD-L1 in NSCLC and clinicopathologic feature, EGFR gene mutation.@*METHODS@#The protein expression of PD-1 and PD-L1 was detected by immunohistochemistry from 127 patients with NSCLC and EGFR gene mutation was detected by quantitative polymerase chain reaction (qPCR) to analyze its relation with clinicopathologic feature. Also, the correlation between protein expression of PD-1 and PD-L1 and EGFR mutation.@*RESULTS@#The PD-1 positive expression in NSCLC tumor cells and tumor infiltrating immune cells is 53.5% (68/127), PD-L1 is 57.5% (73/127). The PD-1 and PD-L1 expression significantly higher in well-differentiated and moderately-differentiated carcinoma than poorly differentiated carcinoma, I+II than III+IV in clinical staging (P<0.05). The EGFR mutation rate was 46.5% (59/127), correlate with female, without smoking history, adenocarcinoma and well-differentiated and moderately-differentiated patients respectively higher than male, smoking history, squamous carcinoma and poorly differentiated patients (P<0.05). The protein expression of PD-L1 and PD-1 had the consistency in NSCLC patients (kappa=0.107,5, P=0.487). There was a negative correlation between the EGFR mutation and PD-1 and PD-L1 expression (Φ=-0.209, Φ=-0.221, P<0.05). Follow-up of NSCLC patients, the median total survival in under the age of 65, adenocarcinoma, well-differentiated and moderately-differentiated, with PD-L1 expression patients respectively higher than over the age of 65, squamous carcinoma, poorly differentiated, without PD-L1 expression patients (P<0.05). The median survival of hypo expression patients of PD-L1 significantly higher than hyper expression patient (P=0.04).@*CONCLUSIONS@#According to the Chinese Expert Consensus on Standards of PD-L1 immunohistochemistry testing for NSCLC, we tested the PD-L1 expression in NSCLC and then the dominant population of anti-PD-1/PD-L1 treatment was screened out. Patients with EGFR mutation were also detected and EGFR mutation was negatively correlated with the expression of PD-1 and PD-L1 as well. On the basis of PD-L1 expression and EGFR mutation status, it may benefit NSCLC patients from individualized treatment. Meanwhile, patients who were under the age of 65, adenocarcinoma, well-differentiated and moderately-differentiated, hypo expression of PD-L1 have a relatively good prognosis, to provide reference for the prognosis evaluation of NSCLC.

The effect of NP regimen plus concurrent irradiation on cancer cell survival of human lung adenocarcinoma / 中国医师进修杂志

Objective To study the effect of NP regimen plus concurrent irradiation on cancer cell survival of human lung adenocarcinoma.Methods A549 and H1299 cells were served as the experimental objects and they were divided into irradiation group (A group),and vinorelbine tartrate injection plus cisplatin with concurrent radiotherapy group (B group).According to the different irradiation doses A group and B group were divided into A-0,A-4,A-8 group and B-0,B-4,B-8 group.MTT was performed to measure the effect of NP regimen plus concurrent irradiation on the cell proliferation,and FACS was used to detect the effect of NP regimen plus concurrent irradiation on apoptosis and P-gp expression.Results Except the cell inhibition rate of B-0 group and A-0 group had no significant difference,the cell inhibition rate of B-0,B-4 and B-8 group at 6,12,24 and 48 h were significantly lower than those of A-0,A-4 and A-8 group.The apoptosis rate of A-8 group [(45.34 ±4.77)％] was significantly higher than that of A-4 group [(20.19 ± 3.76)％] (t =7.17,P =0.006),the apoptosis rate of A-4 group was significantly higher than that of A-0 group [(4.01 ± 0.95)％] (t =7.23,P=0.019).The apoptosis rate ofB-8 group [(51.12 ± 3.37)％]was significantly higher than that of B-4 group[(36.18 ± 4.73)％] (t =3.59,P =0.037),the apoptosis rate of B-4 group was significantly higher than that of B-0 group [(14.78 ± 2.37)％] (t =9.00,P =0.003).The apoptosis rate of B-0 group [(14.78 ± 2.37)％] was significantly higher than that of A-0 group [(4.01±0.95)％] (t =7.31,P =0.018),the apoptosis rate of B-4 group was significantly higher than that of A-4 group (t =4.58,P=0.020),but there was no significant difference between B-8 group and A-8 group (t =1.71,P =0.185).The S cycle percentage of cells in B-0,B-4 and B-8 groups were significantly higher than those of A-0,A-4 and A-8 group (P ＜0.05).There were no significant differences among the P-gp fluorescence intensity of A-0,A-4 and A-8 group (P ＞ 0.05).The P-gp fluorescence intensity of B-0 group was significantly lower than that of A-0 group (t =-3.45,P =0.041),the P-tp fluorescence intensity of B-4 group was significantly lower than that of A-4 group(t =-5.85,P =0.010).The P-gp fluorescence intensity of B-8 group was significantly lower than that of A-8 group (t =-8.07,P =0.015).The P-gp fluorescence intensity of B-4 group was significantly lower than that of B-0 group (t =-8.07,P=0.015),and there was no significant difference between the mean fluorescence intensity of B-4 group and B-8 group (t =-3.56,P =0.071).Conclusion NP regimen plus concurrent irradiation could significantly inhibit the proliferation and apoptosis of human lung cancer cells,and decrease the expression of P-gp in lung cancer cells.

Clinical value of serum COX-2 in predicting patients′ responses to targeted therapy for advanced NSCLC / 实用医学杂志

Objective To explore the clinical value of expression levels of serum COX-2 in patients with advanced NSCLC before and after EGFR-TKI treatment. Methods The serum was collected from 58 cases. Before and after targeted therapy , the serum COX-2 level was examined by ELISA. Meanwhile , CT scan was exercised to evaluate the treatment. Follow-up interview was done. The relationship among the change in expression level of serum COX-2 , efficacy and PFS was analyzed. Results The serum COX-2 level significantly decreased in the response group (t = 11.258, P = 0.000) and increased in the PD group (t = -7.759, P =0.000) after EGFR-TKI treatment, and not significantly changed in the SD group (t = 1.424, P = 0.170). Before treatment, the baseline serum COX-2 level in the response group was significantly higher than that in the SD group and the PD group (F = 20.852, P = 0.000 ). Before the targeted therapy, the higher the level of serum COX-2 was, the longer PFS patients would enjoy. Conclusion Detection of the serum COX-2 contributes to the judgment of therapeutic effect of EGFR-TKI and can be used as a prediction of EGFR-TKI drugs outcomes for patients with advanced NSCLC.

Relationship between serum carcinoembryonic antigen and EGFR mutation in recurrent non-small cell lung cancer / 实用医学杂志

Objective To investigate the relationship of epidermal growth factor receptor (EGFR) mutation with clinical features of baselines as well as serum CEA level in patients with recurrent non-small cell lung cancer (NSCLC). Methods A total of 54 patients with first recurrence of advanced lung cancer who had received chemotherapy were included in this study. ADx-ARMS was performed to detect EGFR gene mutations in surgical specimens taken from the primary tumor. Serum CEA level was measured by the electrochemical luminescence method. Results The mutation rate of EGFR was significantly higher in females than in males (χ2= 11.868, P =0.006), with a total mutation rate of 60.8%in 106 patients. The rate was higher in adenocarcinoma than in other histological types(χ2=6.002,P=0.014), and significantly higher in non-smokers than in smokers (χ2= 8.502,P=0.004) and in the patients with serum CEA level over or equal to 5.0 ng/mL than those with CEA level less than 5.0 ng/mL (χ2=22.543,P=0.000). A multivariate analysis revealed that a higher serum CEA level at the time of disease recurrence was associated with EGFR gene mutations (P = 0.002). Conculsions Serum CEA level is closely associated with the presence of EGFR gene mutations in patients with first recurrence of advanced NSCLC. A higher serum CEA level at the time of disease recurrence is independently associated with EGFR gene mutations. CEA level can be used as a potential indicator to determine EGFR mutation.

Clinical features and genetic sequences of severe fever with thrombocytopenia syndrome bunyavirus in a new-epidemic region of Zhejiang Province, China / 中华传染病杂志

ObjectiveTo investigate the clinical characteristics,epidemiology of patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and genetic sequences of SFTSV.MethodsClinical data of five cases of severe fever with thrombocytopenia syndrome (SFTS)from Zhoushan Hospital during May 2011 to July 2011 were retrospectively analyzed.SFTSV gene was amplified by polymerase chain reaction (PCR).CD3+ CD4+ and CD3+ CD8+T lymphocytes were detected by flow cytometry (FCM).The sequences of isolated SFTSV strains were compared with those in GenBank. ResultsThe symptoms of continuous high fever,sore muscles,enlarged superficial lymph nodes,abdominal pain,diarrhea with gastrointestinal hemorrhage were observed.The white blood cells,platelets and CD3+ CD4+ T lymphocytes were progressive decreased in acute phase with the minimum of (0.97-2.00) × 109/L,(12-42) × 109/L and 7.52％-20.39％,respectively.The SFTSV was isolated from the sera of two patients.The sequences were compared with SFTSV sequences in GenBank.The homology of RNA-dependent RNA polymerase gene was 96％ compared with BX-2010,L-WWG,LN3,JS4,SD4,HN6 and AH12; the glycoprotein gene was 94％ ; N protein gene was 95％ compared with JS4,SD4 and LN4.The homology of the above three genes between two isolates was 99％.ConclusionsOur results suggest that SFTSV is sporadic in Zhejiang Province which is probably from native epidemic focus.SFTS is progressive and severe with acute onset.Multiple organ dysfunction is common in severe eases.

Correlation of serum total bile acid levels with liver tissue inflammation grade in chronic liver diseases / 中华临床感染病杂志

Objective To investigate the correlation of serum total bile acid (TBA) levels with the inflammation grades of liver tissue in chronic liver diseases.Methods Cyclophorase assay was used to detect the serum TBA levels in 172 patients with various chronic liver diseases,and the inflammation grades of liver tissue were determined by liver biopsy.The correlation between serum TBA levels and the inflammation grades of liver tissue was evaluated using SPSS 12.0 software.Results Serum TBA level was positively correlated with the inflammation grade of liver tissue ( r =0.275,P ＜ 0.01 ).The inflammation grade reached G2 when serum TBA was 20 μmol/L.Conclusion Serum TBA level may be useful for evaluating the inflammation grade of liver tissue in chronic liver diseases.

Clinical research on conservative treatment and surgical treatment for bronchiectasis / 中国基层医药

Objective To compare the curative effect of conservative treatment and surgical treatment for bronchiectasis. Methods 60 patients with bronchiectasis were randomly divided into observation group and control group,30 cases in each group,they were treated with surgery and medical therapy respectively,the clinical efficacy,length of stay, costs, remission time of symptoms and signs, changes of blood gas index and ESR, CRP,TNF-α, WBC,NEUT of the two groups after treatment were compared. Results The curative rate of observation group was significandy higher than control group, while the length of stay, remission time of symptoms and signs and hospitalization costs were significantly lower than control group, the difference was statistically significant (all P ＜0.05) ;After treatmenit,the blood gas index of both groups improved significantly than before treatment(all P ＜ 0.05), and the blood gas index of observation group improved significantly than the control group (all P ＜ 0. 05); After treatment, ESR, CRP,TNF-α,WBC and NEUT of both groups were significantly decreased compared with those before treatment(all P ＜0. 05); Between the two groups, the index value of the observation group decreased significantly (all P ＜ 0.05).Conclusion Surgical treatment for bronchiectasis was superior to conservative treatment with better curative effect,lower cost, shorter hospital stay and faster relief of symptoms and signs, it had good prospects to be applied.

Analysis and retreatment on postoperative recurrence of benign thyroid nodules / 中国普通外科杂志

Objective To investigate the factors associated with postoperative recurrence of benign thyroid nodules and its retreatment. Method A retrospective analysis was made on the pathologies, operative indications, and the types of operations in 51 postoperative recurrent cases with benign thyroid nodules in a poriod of 18 years. Result The recurrences were associated with the pathology, number of nodules, the indications and types of primary surgery. Among the 51 cases there were 29 cases with nodular goiter and 22 cases with thyroid adenoma. 21 patients had had simple nodular resection, 16 patients had partial lobe resection, 9 patients had subtotal thyroidectomy and 5 patients had thyroid lobectomy. Among 38 cases receiving reoperation, 19 cases had lobectomy, 3 cases had lobectomy plus opposite subtotal thyroidectomy, 7 cases had subtotal thyroidectomy and 9 cases had bilateral subtotal thyroidectomies without serious postoperative complications. 32 cases were followed up after secondary operation with an average period of 7 years, among which 1 case with multinodular goiter had recurrence. Conclusion Strict restriction on thyroidectomy for patients with mutinodular goiter and giving up simple nodular enucleation could help reduce postoperative recurrence of benign thyroid nodules.