MRI cortical thickness of bulbar region and impacts on survival in amyotrophic lateral sclerosis patients / 西安交通大学学报(医学版)

【Objective】 To investigate cortical thickness changes in the face-head region of the primary motor cortex (PMC) and its effect on survival in amyotrophy lateral sclerosis (ALS) patients. 【Methods】 A retrospective analysis was performed on 105 ALS patients who underwent head MRI scan at the same time. The A4hf (face-head) region of PMC was used as the region of interest (ROI). According to clinical symptoms, patients were divided into two groups: bulbar involvement and non-bulbar involvement. The differences of clinical features and cortical thickness in ROI were analyzed. According to the symptoms of bulbar palsy, physical examination of nervous system and EMG of tongue muscle, the patients with bulbar palsy were divided into lower motor neuron (LMN), upper motor neuron (UMN) and LMN+UMN groups. The differences of bulbar subgroup score and ROI of cortical thickness were analyzed. Age at onset, body mass index, delayed time of diagnosis, bulbar subgroup score, and ROI cortical thickness were included in survival analysis. 【Results】 ① The ROI cortical thickness was significantly lower in bulbar involvement group than non-bulbar involvement group (-0.198±0.87 vs. 0.235±0.95, P=0.017). ② There were no significant differences in the bulbar subgroup scores or cortical thickness of ROI between LMN, UMN and LMN+UMN groups (P>0.05). ③ Survival analysis showed age of onset (HR=3.296, 95% CI:1.63-6.664, P=0.001), delayed time of diagnosis (HR=0.361, 95% CI:0.184-0.705, P=0.003), bulbar subgroup score (HR 0.389, 95% CI:0.174-0.868, P=0.021), and ZRE_ROI cortical thickness (HR=2.309, 95% CI:1.046-5.096, P=0.038) were independent influencing factors of ALS survival. 【Conclusion】 Cortical thickness in A4hf (face-head) region can more objectively reflect UMN signs of region bulbar. In addition to age of onset and delayed time of diagnosis, bulbar subgroup score and cortical thickness of face-head region are also independent influencing factors, and cortical thinning in face-head region is a protective factor for survival of ALS patients.

Identification and clinical transfusion of B (A) subgroup / 中国输血杂志

【Objective】 To carry out serological and molecular biological identification of B (A) subtype, and discuss the rational blood transfusion strategy. 【Methods】 Serological and direct sequencing methods were used to detect serotype and genotype of 7 cases of B (A) subtype, and cross matching was performed by saline medium and anti human globulin card to analyze the red blood cells(RBCs) transfusion strategy. 【Results】 The serology results of blood type of 7 samples were similar, with B(A)04/O01 in 3 cases, B(A)04/O02 in 2 cases and B(A)02/O01 in 2 cases. 7 cases of B (A) subtypes were matched with randomly selected blood donors of type O and B on the major side. 【Conclusion】 B(A) subtypes should be identified by genotyping techniques. Washed RBCs of type B and O can be used for B(A) blood type transfusion.

Analysis of Chinese Medical Syndrome Features of Ischemic Stroke Based on Similarity of Symptoms Subgroup / 中国结合医学杂志

OBJECTIVE@#To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients.@*METHODS@#By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup.@*RESULTS@#Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens.@*CONCLUSIONS@#There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.

A novel biological sources consistency evaluation method reveals high level of biodiversity within wild natural medicine: A case study of Amynthas earthworms as "Guang Dilong"

For wild natural medicine, unanticipated biodiversity as species or varieties with similar morphological characteristics and sympatric distribution may co-exist in a single batch of medical materials, which affects the efficacy and safety of clinical medication. DNA barcoding as an effective species identification tool is limited by its low sample throughput nature. In this study, combining DNA mini-barcode, DNA metabarcoding and species delimitation method, a novel biological sources consistency evaluation strategy was proposed, and high level of interspecific and intraspecific variations were observed and validated among 5376 Amynthas samples from 19 sampling points regarded as "Guang Dilong" and 25 batches of proprietary Chinese medicines. Besides Amynthas aspergillum as the authentic source, 8 other Molecular Operational Taxonomic Units (MOTUs) were elucidated. Significantly, even the subgroups within A. aspergillum revealed here differ significantly on chemical compositions and biological activity. Fortunately, this biodiversity could be controlled when the collection was limited to designated areas, as proved by 2796 "decoction pieces" samples. This batch biological identification method should be introduced as a novel concept regarding natural medicine quality control, and to offer guidelines for in-situ conservation and breeding bases construction of wild natural medicine.

Cost-effectiveness analysis of serplulimab combined with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma / 中国药房

OBJECTIVE To evaluate the cost-effectiveness of serplulimab combined with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma from the perspective of the Chinese healthcare system. METHODS A partitioned survival model with three health states was constructed for cost-effectiveness analysis. Clinical data were extracted from ASTRUM- 007. Information on parameters such as cost and health utility was derived from related websites and published literature. The quality-adjusted life years （QALYs） was used as the output index to calculate the incremental cost-effectiveness ratio （ICER）， and then compared with three times the per capita gross domestic product （GDP） in China to judge whether it was cost-effective. One- way sensitivity analysis and probabilistic sensitivity analysis were performed to evaluate the robustness of the model； the cost- effectiveness of applying this plan to subgroup patients with programmed cell death-ligand 1 combined positive score （PD-L1 CPS） ≥10 and the scheme in the context of charitable drug donations was explored. RESULTS Among advanced or metastatic oesophageal squamous cell carcinoma patients and patients with PD-L1 CPS ≥10， serplulimab combined with chemotherapy could improve health outcomes with an augmentation of cost， compared with placebo combined with chemotherapy，resulting the ICERs were 599 623.64 yuan/QALY and 629 121.57 yuan/QALY， respectively. Therefore， serplulimab combined with chemotherapy was not cost-effective. Sensitivity analysis of single factor showed that the costs of serplulimab were the crucial factor affecting the ICER； probabilistic sensitivity analysis demonstrated basic analysis results were relatively robust. The results of scenario analysis showed that when all patients met the requirements of the charitable drug donation program， serplulimab combined with chemotherapy was cost-effective； the economic outcome of this scheme was reversed compared with the results of the basic analysis. CONCLUSIONS From Chinese healthcare perspective， first-line treatment with serplulimab in combination with chemotherapy is not a cost-effective option for patients with advanced esophageal squamous cell carcinoma， but it may be an economic option to implement a charitable drug donation program for all patients or if the price of serplulimab is significantly reduced.

Efficacy and safety of cinepazide maleate injection in acute ischemic stroke patients with obvious motor function deficit / 中华神经科杂志

Objective:To confirm the efficacy and safety of cinepazide maleate injection in acute ischemic stroke patients with obvious motor function deficit.Methods:This study is a subgroup analysis of multi-center, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial. A total 812 patients of acute ischemic stroke with obvious limb motor deficit [motor function of limbs score in National Institutes of Health Stroke Scale (NIHSS) ≥4] were enrolled in this subgroup analysis. Patients received either cinepazide maleate injection or placebo. The treatment period was 14 days and follow-up was 90 days. The efficacy endpoints included the proportions of patients with a modified Rankin Scale (mRS) score ≤2, mRS score ≤1 and Barthel Index <95 on day 90. Safety was evaluated by recording all adverse events, monitoring vital signs, laboratory parameters and electrocardiogram.Results:A total of 732 patients were involved in the final efficacy analysis (361 in cinepazide maleate group and 371 in control group). The baseline limb motor function score of NIHSS was 5.23±1.43 in the cinepazide maleate group whereas 5.20±1.36 in the control group. Logistic regression analysis showed that following treatment for 90 days, the proportion of patients with a mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group [56.0% (202/361) vs 44.2% (164/371), OR=0.60, 95% CI 0.44-0.82, P=0.002]. The proportion of patients with a mRS score ≤1 was higher in the cinepazide maleate group than in the control group [43.3% (139/361) vs 35.2% (118/371), OR=0.69, 95% CI 0.50-0.97, P=0.031]. The proportion of patients with a Barthel Index <95 on day 90 was significantly lower in the cinepazide maleate group than in the control group [45.2% (145/361) vs 55.2% (185/371), OR=0.64, 95% CI 0.46-0.88, P=0.007]. During the treatment and follow-up period, the incidence of the most common adverse events in the cinepazide maleate group was 50.4% (199/395). Constipation and abnormal liver function were more common, but there were no statistically significant differences between the two groups. Conclusion:Cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery and safe in patients with acute ischemic stroke with obvious limb motor deficit.

Biological identification and molecular structure model analysis of Bx02 / 中国输血杂志

【Objective】 To identify two ABO discrepancy samples and explore the molecular mechanism. 【Methods】 The serological phenotype of the proband was determined with standard serological methods. ABO genotype was determined by polymerase chain reaction-sequence specific primer (PCR-SSP). Exon 6 and 7 of the ABO gene were amplified with PCR and sequence-based typing (SBT). The amplicon of exon 6 and 7 was also cloned and sequenced. Pymol software was used to simulate the 3D structural model and predict the effect of GTB protein mutation on the structure. The sample were collected from proband’s father and analyzed. 【Results】 The proband’s erythrocytes were detected with B antigens, along with the presence of anti-B in serum. The genotype O1/B of the proband was identified by PCR-SSP. Direct sequencing of the proband revealed 261delG/G, 297A/G in exon 6 and 526C/G, 646A/T, 657C/T, 681A/G, 703A/G, 771C/T, 796A/C, 803C/G, 829A/G, 905A/G, 930A/G, 1096A/G heterozygote in exon 7, which was assigned as Bx02/O02 genotype. Clone sequencing showed that a 905 A>G mutation in the ABO*B.01 allele. The 3D structure simulation suggested that Asp302Gly may cause the change of GTB enzyme activity or function. 【Conclusion】 Two cases of Bx02 allele were identified. Combined detection of serological and genotyping methods is important for identification of ABO blood group.

Identification of Hypertension Subgroups through Topological Analysis of Symptom-Based Patient Similarity / 中国结合医学杂志

OBJECTIVE@#To obtain the subtypes of the clinical hypertension population based on symptoms and to explore the relationship between hypertension and comorbidities.@*METHODS@#The data set was collected from the Chinese medicine (CM) electronic medical records of 33,458 hypertension inpatients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between July 2014 and May 2017. Then, a hypertension disease comorbidity network (HDCN) was built to investigate the complicated associations between hypertension and their comorbidities. Moreover, a hypertension patient similarity network (HPSN) was constructed with patients' shared symptoms, and 7 main hypertension patient subgroups were identified from HPSN with a community detection method to exhibit the characteristics of clinical phenotypes and molecular mechanisms. In addition, the significant symptoms, diseases, CM syndromes and pathways of each main patient subgroup were obtained by enrichment analysis.@*RESULTS@#The significant symptoms and diseases of these patient subgroups were associated with different damaged target organs of hypertension. Additionally, the specific phenotypic features (symptoms, diseases, and CM syndromes) were consistent with specific molecular features (pathways) in the same patient subgroup.@*CONCLUSION@#The utility and comprehensiveness of disease classification based on community detection of patient networks using shared CM symptom phenotypes showed the importance of hypertension patient subgroups.

Bidirectional regulation of acupuncture: a subgroup analysis of multicenter randomized controlled trial of acupuncture with / 中国针灸

OBJECTIVE@#To explore the bidirectional regulation of acupuncture based on a subgroup analysis of multicenter randomized controlled trial of acupuncture with @*METHODS@#A total of 519 patients were included in the analysis, including 137 patients with constipation type irritable bowel syndrome (IBS-C) (92 cases in the acupuncture group and 45 cases in the polyethylene glycol [PEG] group), and 382 patients with diarrhea type irritable bowel syndrome (IBS-D) (252 cases in the acupuncture group and 130 cases in the pinaverium group). The patients in the acupuncture group were given acupuncture at Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) once every other day, 3 times a week. The patients in the PEG group received polyethylene glycol 4000 powder orally, and the pinaverium group received pinaverium bromide tablets orally. All were treated for 6 weeks. The IBS symptom severity score (IBS-SSS) was assessed at baseline, treatment period (2, 4, 6 weeks of treatment) and 12 weeks of follow-up, and the IBS quality of life (IBS-QOL) score was evaluated at the baseline period, 6 weeks of treatment and 12 weeks of follow-up.@*RESULTS@#The total IBS-SSS scores of the two groups of IBS-C patients at 2, 4, 6 weeks of treatment and follow-up of 12 weeks were lower than those in the baseline period (@*CONCLUSION@#Acupuncture with

Frequency of A2B Among the AB Blood Group Donors

Objective: The aim of the study is to detect the frequency ofA2B blood groups among the AB donors.Method: This cross-sectional observational study which wascarried out at Transfusion Medicine department, BangabandhuSheikh Mujib Medical University, Dhaka from January 2018 toJuly 2018 over 142 subjects. After selection of healthy donorsblood group was detected by standardized tube technique.Anti- A1 lectin study was done for all blood donors with bloodgroup AB. Based on the serological reactivity, blood group wasclassified into A2B and Rh-D negative or positive.Results: In the study, it was found that among 142 AB bloodgroup donors, majority blood donors were male 130 (91.5%)and rest were female 12 (8.5%). Among 10 A2B blood groupdonors 25% were female and 5.38% were male. More than halfdonors 78 (54.9%) belonged to age 21-30 years. The meanage was 27.68 SD±6.76 years with ranged from 18 to 50years. It was observed that 132 (93.0%) belonged to A1Bsubgroup and 10 (7.0%) belonged to A2B subgroup. The studyalso revealed that 126 (95.5%) A1B individuals were Rhpositive, 6 (4.5%) A1B individuals were Rh-negative. All A2Bindividuals were found Rh-positive.Conclusion: From our study we found that, the frequency ofA2B among the female donors is more than four times higherthan the male donors. As the A2B is the rare subgroup but thefrequency of this subgroup in this study recommend the extraattention for the physician and staff working in the TransfusionMedicine department.

Research progress on myasthenia gravis related autoantibody and detection approaches / 上海交通大学学报（医学版）

Myasthenia gravis (MG) is an autoimmue disease mediated mainly by humoral immunity, which is characterised by skeletal muscle weakness and fatigue. Its pathogensis is closely related to the autoantibodies against the postsynaptic membrane components at neuromuscular junction (NMJ), including acetylcholine receptor (AChR) antibody, muscle-specific receptor tyrosine kinase (MuSK) antibody, and low-density lipoprotein receptor-related protein 4 (LRP4) antibody. In recent years, autoantibodies against antigens such as agrin, collagen Q, and cortactin have been identified. Based on serum antibody patterns, MG can be divided into different subgroups: AChR-MG, MuSK-MG, LRP4-MG and seronegative MG. The detection of autoantibody is vital in clinical for subgroup diagnosis, treatment and prognosis. With the development of medical techniques, the antibody detection approaches were improved, providing new opportunities for precise diagnosis and treatment of different subgroups. Thus, this paper reviewed the latest progress of MG autoantibody classification and the antibody detection approaches.

Predictive value of age and serum neuron enolase analysis in the pathological prognosis of histopathology sub-group in intermediate and high-risk neuroblastoma / 中华实用儿科临床杂志

Objective To improve substantially the prediction accuracy of histopathology subgroup through combined analysis of clinical and biological features,and accordingly build a decision tree to predict the histopathology subgroup in intermediate and high - risk neuroblastoma. Methods A total of 62 intermediate and high - risk neuro-blastoma patients were included retrospectively in this study,who received chemotherapy and surgery at Beijing Chil-dren's Hospital (BCH),Capital Medical University between January 2015 and January 2017. The fin-dings of urinary vanillylmandelic acid (VMA),and homovanillic acid (HVA),serum neuron - specific enolase (NSE),lactate dehy-drogenase (LDH)and ferritin,ultrasound,CT,MRI,positron emission tomography - computed tomography (PET -CT),bone marrow aspiration and biopsy,MYCN gene,and histopathology were collected and analyzed retrospectively. Statistical analysis was performed by using SAS 9. 4. Univariate and multivariate Logistic regression analysis were con-ducted to select potentially useful characteristics for prediction. Based on the results of Logistic regression analysis,a classification tree was developed to predict histopathology subgroup. Results To identify the characteristics related to histopathology,tumor markers and six clinico - pathologic factors were evaluated by univariate analysis. The results showed that unfavorable histopathology(UH)was more frequently associated with bone marrow metastasis,older age,as well as higher serum NSE,ferritin and LDH levels. The result of multivariate analysis showed that age and NSE were significant independent predictors of histopathology. The adjusted odds ratio(OR)of NSE and age was 33. 2 and 13. 0, respectively. The area under the receiver - operating - characteristic (AUC)of the prediction mo-del was 0. 889. The sensitivity and specificity were 91. 90％ and 76. 00％,respectively. Furthermore,to provide a visua-lization of the sig-nificant predictors found by Logistic regression analysis,a decision tree was developed for predicating of histopathology. Conclusions Age and NSE are significant independent predictors of histopathology subgroup. The decision tree based on age and NSE can help to predict the histopathology subgroup in intermediate and high - risk neuroblastoma effective-ly.

Identification of Respiratory Syncytial Virus A and B Subtypesby Tube Double Nested Polymerase Chain Reaction and Gene Sequencing Technology / 现代检验医学杂志

Objective Objective to establish a method for identification of respiratory syncytial virus (RSV) A and B subtypes for clinical research and application.Methods Using fluorescent quantitative polymerase chain reaction (FQ-PCR) screened 50 cases of throat swab that RSV were positive in hospitalized children from 2015 to 2017.The genotyping was performed according to the nucleotide sequence of G protein coding gene,and a single tube double nested PCR primers was designed for it.A and B subgroup by sequencing to conduct comparative analysis with nucleotide sequence in the Genebank.The results were analyzed by chi-square test.Results In the 50 cases of throat swab RSV positive children,respiratory syncytial virus A and B subtype and mixed infection rates were 82.00％,14.00％ and 4.00％,respectively.The difference was statistically significant (x2=81.06,P＜0.01).The RSV fractal results were consistent with the gene sequencing results.Conclusion The eastern part of shenzhen was dominated by respiratory syncytial virus A subtype epidemic and mixed infection.Single tube double nested polymerase chain reaction (PCR) and gene sequencing technique is suitable for the identification of A and B subtypes of RSV.It is characterized by high sensitivity,specificity and high accuracy.

Identification for rare B(A) blood group / 临床检验杂志

Objective To investigate the serological and molecular identification of 2 rare B( A) blood groups. Methods The ABO blood groups of 2 samples from blood donors were detected by routine serological method. The genotype features was identified by PCR-sequence specific primer (PCR-SSP) and direct sequence analysis. Results The serological results for the 2 blood donors showed the characteristics of B(A) phenotype. The sample 1 was genotyped as BO2 subtype by PCR-SSP and direct sequencing showed B alleles in exon 7, presented nt640 A＞G mutation which was confirmed to be B(A)04/O02 genotype.The sample 2 was genotyped as BO1 sub-type by PCR-SSP and direct sequencing showed B alleles presented nt700 C＞G mutation in exon 7 which was confirmed to be B(A)02/O01 genotype. Conclusion The phenotype of the two samples should be B ( A ) and the genotypes should be rare B(A)04/O02 and B(A)02/O01.

Subgroup identification based on the Logistic model / 南方医科大学学报

We propose a subgroup identification method based on the Logistic model for data from a two-arm clinical trial with dichotomous outcome variables.In this method, binary Logistic regression models are established for each group to calculate the outcome probabilities of each patient for comparison.According to the established rules, the patients are classified into their corresponding subgroups to establish a multinomial Logistic regression model.We simulated the false rate, correct judgment rate, coincidence rate and model correct judgment rate for different sample sizes and carried out an example analysis.The results of simulation showed that for different sample sizes, the false rates of this method were below 0.07 and the correct judgment rates were all above 0.75 with adequate coincidence rates and model correct judgment rates, demonstrating the effectiveness and reliability of the proposed method for subgroup identification.

Clinical application of high mobility group box nuclear protein 1 subcomponent in the progression of liver cancer / 中华肝脏病杂志

The biological functions of high-mobility group (HMG) proteins include regulation of DNA replication, transcription, recombination and repair. According to molecular weight, sequence alignment and DNA structural characteristics, HMG proteins are subdivided into three superfamilies (HMGA, HMGB and HMGN). Recently, HMGB family members (HMGB1, HMGB2, HMGB3, and HMGB4) found to interact with hepatitis B or C virus. Therefore, activation of relevant signaling molecules to regulate transcription of genes related to hepatocellular carcinoma as a mediator of inflammation promoting HCC progression has attracted considerable attentions. This article focuses on the clinical application of the expression of HMGB family members in the process of HCC progression.

The study of clinical indicators for identification of colonization and infection of Acinetobacter baumannii / 安徽医科大学学报

Objective To explore the clinical significance of T lymphocyte subsets and cytokines in the identifica-tion of Acinetobacter baumannii colonization and infection. Methods A total of 109 patients in hospital who had A. baumannii in sputum were collected. All patients were divided into colonization group (53 cases) and infection group (56 cases) according to the diagnostic criteria of hospital-acquired pneumonia by respiratory society, Chinese medical association. Another 50 healthy cases as control group. T lymphocyte subgroup and cytokines in peripheral blood were measured, the differences of T lymphocyte subgroup or cytokines between the groups were also com-pared. The factors of T lymphocyte subgroup or cytokines were analyzed by Spearman correlation analysis. Logistic regression analysis was used for investigating the predictors for the infection of A. baumannii. Results Between colonization group and infection group, the significant differences were been found in T lymphocytes subgroup, TNF-α,IFN-γ and IL-17. The A. baumannii infection was positively associated with TNF-α ( rs=0.241, P =0.012), IFN-γ (rs=0.235, P=0.014), IL-2(rs=0.249, P=0.009), IL-4(rs=0.268, P=0.005) and IL-17 (rs=0.538, P=0.000), whereas which was negatively associated with CD3 +(rs= -0.193, P=0.045) and CD4 +/CD8 +(rs= -0.302, P=0.001). IFN-γ and IL-17 was the independent factors for discrimination of A. baumannii infection by multivariate Logistic regression analysis. Conclusion Serum IFN-γ, IL-17 can be used as an indicator of Acinetobacter baumannii infection and colonization, and can provide a basis for the rational use of antimicrobial agents and nosocomial infection prevention and control.

Prognostic and subgroup analysis of 162 patients with Barcelona Clinical Liver Cancer (BCLC)stage B hepatocellular carcinoma after hepatectomy / 中华肝胆外科杂志

Objectives To analyze prognosis and risk factors of Barcelona Clinical Liver Cancer (BCLC) stage B hepatocellular carcinoma patients treated with hepatectomy.Methods Clinical data of 162 BCLC stage B patients who underwent hepatectomy at Tianjin Medical University Cancer Institute & Hospital and the Second Hospital of Tianjin Medical University from June 2007 to December 2013 were retrospectively studied.The correlations between factors (age,gender) and long-term outcome were analyzed to determine independent risk factors.Subsequently,subgroup analysis of BCLC stage B hepatocellular carcinoma was performed.Results Multiple tumors,maximum tumor diameter ＞ 10 cm and AFP ＞ 100 μg/L were con firmed as independent risk factors of overall survival in postoperative BCLC B patients.Based on the risk factors,patients were divided into two groups,namely low-risk subgroup (≤ 1 risk factor) and high-risk subgroup (≥ 2 risk factors).In low-risk subgroup,1,3 and 5-year overall survival (OS) rates were 91.6％,65.5％,61.9％ respectively,and mean OS was 72 months.By contrast,1,3 and 5-year OS rates in high-risk subgroup were 67.4％,25.6％,10.8％ respectively,and mean OS was 29 months.Further more,1,3 and 5-year OS rates of all patients were 85.2％,54.9％,48.0％ respectively,and mean OS was 61 months.Conclusions Relatively favorable long-term outcomes could be yielded in BCLC stage B hepatocellular carcinoma patients treated with liver resection.The independent risk factors including multiple tumors,maximum tumor diameter ＞ 10 cm and AFP ＞ 100 μg/L were closely correlated with overall survival.BCLC stage B hepatocellular carcinoma patients could be divided into low-risk and high-risk subgroups based on the risk factors mentioned above.Survival rates in low-risk subgroup are remarkably superior to those in high-risk subgroup.

Expression of T cell subgroup and cytokines in the peripheral blood of patients with silicosis and their significance / 中国综合临床

Objective To explore the expression of peripheral T cell subgroup (CD3+,CD4+,CD8+,CD4+CD25 high regulatory T cells) and the level and significance of serum cytokines in patients with silicosis.Methods One hundred and six cases patients with silicosis were collected in the Fifth People''s Hospital of Suzhou as study subjects and 56 healthy subjects as control group.Flow cytometry was used to detect the peripheral CD3+,CD4+,CD8+ and CD4+CD25 high regulatory T cells (Treg) of the patients and the control group,while chemiluminescence immunoassay was utilized to measure the peripheral serum soluble interleukin-2 receptor (sIL-2R),interleukin 6 (IL-6),interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α).Results (1) The percentages of peripheral CD3+,CD4+ and CD8+ in the silicosis group were all lower than those in the control group (t=3.755,3.828,2.347,P<0.05);the percentage of Treg cells was higher in the silicosis group than in the control group,the difference was statistically significant (t=-8.345,P<0.05).Compared with the control group,based on the one-way analysis of variance,the differences in CD3+,CD4+,CD8+ and CD4+CD25 high cells were all statistically significant (F=5.620,8.007,26.71,P<0.05);in the silicosis group,the percentage of CD4+ T cells was lower in stage III than in stage I (t=3.424,P<0.05);compared with the control group,the percentages of Treg cells in the silicosis group were lower in all stages (t=-7.934,-9.445,-5.096,P<0.05).(2) The levels of peripheral sIL-2R,IL-6,IL-8 and TNF-α in the silicosis group were higher than those in the control group,the difference were statistically significant(t=-6.952,-4.506,-2.551,-5.670,P<0.05);compared with the control group,based on the one-way analysis of variance,the differences in sIL-2R,IL-6 and TNF-α in all stages were statistically significant (F=11.03,11.31,13.22,P<0.0001);the sIL-2R was higher in patients with stage III silicosis than that of stage I (t=-2.882,P<0.05);IL-6 was significantly higher in stage II and III silicosis group than that of stage I group (t=-3.022,-2.632,P<0.05),and TNF-α was higher in patients with stage II silicosis than patients with stage I silicosis (t=-2.322,P<0.05).(3) The level of peripheral Treg cells was negatively correlated with the percentages of CD3+ and CD8+ cells in patients with silicosis (r=-0.357,-0.508,P<0.05);sIL-R2 was positively correlated with IL-6,IL-8 and TNF-α,respectively (r=0.483,0.199,0.392,P<0.05);TNF-α was positively correlated with IL-6 and IL-8,respectively (r=0.338,0.338,P<0.05).Conclusion Patients with silicosis have abnormal expression in peripheral T cell subgroups,significantly increased Treg cell and dysfunctional cytokines,which may be associated with the pathogenesis of silicosis,the detection of these indicators may have significance of diagnosis,staging,disease monitoring and prognosis of the diseases.

Correlation studies of P-glycoprotein and lymphocyte subgroup in patients with immune thrombocytopenia / 国际检验医学杂志

Objective To discuss the correlation of P-glycoprotein(P-gp) and lymphocyte subgroup(CD4+,CD8+) in patients with immune thrombocytopenia.Methods A total of 20 patients with immune thrombocytopenia were selected from August 2015 to September 2016 in the Eighth Hospital Affiliated to Sun Yat-sen University.According to the platelet count,all patients were divided into mild group and severe group,20 cases of health persons were selected at the same period as the healthy group,flow cytometry technique was used to detect the plasma lymphocyte subsets(CD4+,CD8+) and P-gp level of all the objects.Pearson correlation analysis was used to analyze the relationship between plasma P-gp and plasma CD4+,CD8+,CD4+ / CD8+ level,analyzed all the objects plasma platelet count,P-gp and CD4+,CD8+,CD4+ / CD8+ levels.Results Plasma CD4+,CD8+,CD4+ / CD8+ and P-gp level of severe group were significant higher than those of mild group(t=3.587,2.957,2.315,2.646,P<0.05),plasma CD4+,CD8+,CD4+ / CD8+ and P-gp level of mild group patients were significant higher than those of healthy group(t=5.479,2.921,4.536,7.750,P<0.05).Pearson correlation analysis results showed that the plasma levels of P-gp and plasma CD4+,CD8+,CD4+ / CD8+ levels were positively correlated(r=0.683,0.617,0.548,P<0.05).Conclusion Plasma CD4+,CD8+,CD4+/CD8+and P-gp level is associated with immune thrombocytopenia patients condition,plasma levels of P-gp closely links with abnormal immune function in patients with hyperthyroidism,prompting detection the level of change could help doctors to assess patients medication curative effect.