Résumé
Objectives To explore the expression, biological function, and mechanism of MKI67 in pancreatic cancer and its clinical significance. Methods The expression level, diagnosis, and prognostic value of MKI67 in pancreatic cancer were analyzed using public databases. We also investigated the association between the MKI67 with immune cell infiltration and immune checkpoint molecules. We analyzed the functional pathway enrichment to uncover the possible molecular mechanisms. qRT-PCR and Western blot assay were used to verify the expression of MKI67 mRNA and protein. Immunohistochemistry staining was used to detect the expression of MKI67 in tissue protein. Results The high expression of MKI67 was significantly associated with high histological grades and poor outcomes in pancreatic cancer. High MKI67 expression was correlated with poor prognosis of pancreatic cancer patients (P=0.009). MKI67 was an independent risk factor for the patient outcome (95%CI: 1.084-1.743, P<0.05). The MKI67 expression was positively correlated with the helper T cell 2 levels but negatively correlated with plasmacytoid DC, NK cells, mast cells, the T follicular helper, immune DC, and CD8 T cells. Conclusion MKI67 may serve as a biomarker for the diagnosis and prognosis of pancreatic cancer and the mechanism might be associated with immune escape or immunosuppression.
Résumé
@#While lobectomy is the standard surgical procedure for early-stage non-small cell lung cancer (NSCLC), sublobectomy (segmentectomy/wedge resection) has been gaining progress in early-stage peripheral NSCLC in recent years because it preserves more lung parenchyma and has the advantages of good postoperative lung function, relatively less trauma, and faster recovery. However, there has been a lack of standardized randomized clinical trials to study the survival benefits of sublobectomy. The results of a high-profile study from the USA, CALGB140503, have been the subject of intense industry debate since its presentation at the 2022 World Conference on Lung Cancer (IASLC WCLC 2022). The study, which was published in The New England Journal of Medicine on February 9, 2023, was designed to investigate whether sublobectomy was not inferior to lobectomy in terms of survival in patients with early-stage peripheral NSCLC (tumor diameter≤2 cm). The results showed that sublobectomy was not worse than lobectomy for survival in patients with T1aN0M0 peripheral NSCLC with tumor diameter≤2 cm and pathologically confirmed negative hilar and mediastinal lymph nodes. Sublobectomy, including anatomical segmentectomy and wedge resection is an effective NSCLC treatment. The results of this study provide strong evidence for the improved outcomes of sublobectomy in terms of lung function protection and are expected to promote the further use of sublobectomy. However, given the limitations of this study, whether sublobectomy, especially wedge resection, can become a standard procedure still needs to be explored. This paper presents an interpretation of this study and we invite experts in the field to discuss its usefulness in guiding clinical practice and summarise its limitations.
Résumé
Objective:This study aims to explore the expression of miR-143 in gallbladder cancer tissues and its correlation with tumor angiogenesis, clinicopathologic features and clinical prognosis.Methods:The clinical and pathological data of 78 patients with gallbladder cancer who were surgically resected and pathologically confirmed from January 2008 to June 2016 in the Department of General Surgery, Xuancheng Hospital Affiliated to Wannan Medical College were collected, including 20 males and 58 females, with an average age of (68.0±1.4) years. 78 cases of gallbladder cancer tissue were used as the tumor group, and 32 cases of normal gallbladder tissue adjacent to cancer were randomly selected as the control group. The expression level of miR-143 in the tumor group and the control group was detected by in situ hybridization. Microvessel density (MVD) were evaluated with immunohistochemistry to detect the expression of CD34 in tumor group. The expression of miR-143 and its correlation with tumor MVD, pathological characteristics and prognosis were analyzed by Cox regression analysis.Results:The results of in situ hybridization showed that the positive rate of miR-143 in gallbladder cancer tissues and average expression score were significantly lower than those in adjacent normal gallbladder tissues [29.49% (23/78) vs 62.5% (20/32), χ 2=10.39, P=0.001; (2.705±0.172) vs (4.688±0.405), t=5.33, P<0.001]. Correlation analysis showed that the expression of miR-143 was associated with lymph node metastasis of gallbladder cancer ( P=0.036). The MVD counts in the miR-143 positive group were significantly lower than those in the miR-143 negative group [(126.2±8.483) vs (157.4±6.412), t=2.75, P=0.007)]. The median survival time of gallbladder cancer patients with miR-143 positive and negative was 16 and 9 months, respectively. Cox regression analysis showed that the low expression of miR-143 was an independent risk factor affecting the clinical prognosis of gallbladder cancer. Conclusion:The expression of miR-143 is down-regulated in gallbladder cancer and participates in angiogenesis and clinical prognosis of gallbladder cancer.
Résumé
Chronic diseases have become an important public health problem for people under 70 years of age worldwide， while also causing a great economic burden. The establishment of clinical prediction models can help to predict the risk of a disease or the prognostic effect of a study subject in advance by means of index testing at the early stage of chronic diseases， and plays an increasingly important role in clinical practice. This study introduces clinical diagnostic prediction models and clinical prognostic prediction models， and reviews clinical data processing， clinical prediction model building， visualization methods and model evaluation from the perspective of the application of clinical prediction models， which contribute to the correct and reasonable use of prediction models in clinical research.
Résumé
Objective:To analyze the association between the expression of ubiquinone oxidoreductase complex assembly factor 4 (NDUFAF4) and clinical prognosis of patients with hepatocellular carcinoma (HCC), evaluate the effect of NDUFAF4 on the radiosensitivity of human HCC cell lines, and unravel the underlying mechanism.Methods:The online database and HCC tissue samples were used to investigate the expression of NDUFAF4, and the correlation between NDUFAF4 expression level and clinical prognosis. The si-NDUFAF4 plasmid which down-regulated the expression level of NDUFAF4 was transferred into HepG2 and Huh7 cells. The radiosensitivity of HCC cell lines was detected by clone formation experiment. Nude mice were prepared for tumor-bearing experiment. The β-catenin level was detected by immunofluorescent staining. The expression levels of E-cadherin and N-cadherin proteins were determined by Western blot.Results:Bioinformatics results confirmed that NDUFAF4 was significantly up-regulated in HCC tissues, and the higher the expression level, the worse the patients' clinical prognosis ( P<0.05). The expression level of NDUFAF4 in HCC tissues was significantly higher than that in the adjacent tissues. Clone formation experiment confirmed that knockdown of NDUFAF4 significantly decreased the survival rate of HCC cells ( P<0.01). In vivo experiment showed that knockdown of NDUFAF4 could prevent the proliferation of HCC cells and down-regualte the expression levels of β-catenin and Ki-67. Knockdown of NDUFAF4 significantly down-regulated the expression level of β-catenin protein in the nucleus of HCC cell lines, suggesting that NDUFAF4 could activate the WNT/β-catenin signaling pathway. Knockdown of NDUFAF4 significantly up-regulated the expression level of E-cadherin and down-regulated that of N-cadherin. Conclusions:Knockdown of NDUFAF4 can significantly enhance the radiosensitivity of HCC cell lines by inhibiting the WNT/β-catenin signaling pathway. The expression level of NDUFAF4 is intimately correlated with clinical prognosis. NDUFAF4 can be considered as a new target for lowering the radiation resistance of HCC.
Résumé
Objective:To investigate the clinical efficacy and prognosis of sacubatrovalsartan combined with dapagliflozin in patients with heart failure with reduced ejection fraction (HFrEF).Methods:Totally 206 consecutive patients with HFrEF in our hospital from March 2021 to September 2021 were enrolled and randomly(random number) divided into the control group ( n = 51), the sacubatrovalsartan group ( n = 52), the dapagliflozin group ( n=51) and the combined treatment group ( n= 52). The baseline clinical data of patients and laboratory examination results were collected. The changes of related results before and after treatment in each group were analyzed and compared. After discharge, the enrolled patients were followed up by outpatient or telephone for an average of 6 months to determine whether the patients had heart failure rehospitalization, ventricular arrhythmia, major adverse cardiovascular events (MACE), etc. Results:After anti-heart failure treatment, there were significant differences in NT-proBNP, left ventricular ejection fraction (LVEF) and soluble growth stimulating gene 2 protein (ST2) among the four groups. NT-proBNP and ST2 in the combined treatment group were significantly lower than those in the other groups, and LVEF was significantly higher. Compared with the control group, the rehospitalization due to heart failure and MACE events in the other three groups were significantly lower ( P < 0.05), and the combined treatment group had the lowest ( P < 0.05). The Kaplan-Meier survival curve showed that the survival probability of the other groups was significantly higher than that of the control group, and was the highest in the combined treatment group. Conclusions:The clinical efficacy and prognosis of HFrEF patients could be significantly improved after the treatment of sacubatrovalsartan combined with dapagliflozin.
Résumé
OBJECTIVE@#To investigate the expression and gene function of methyltransferase-like protein 27 (METTL27) in colon cancer, its association with immune infiltration and its prognostic significance.@*METHODS@#We analyzed the expression levels of METTL27 in 33 cancers using R language and identified METTL27 as a differential gene in colon cancer. The related signaling pathways of METTL27 were analyzed by gene functional annotation and enrichment. SsGSEA algorithm was used to analyze immune infiltration, and logistic analysis was used to evaluate the correlation between METTL27 expression and clinicopathological features of the patients. Kaplan-meier analysis, univariate and multivariate Cox regression analysis were performed to construct a nomogram for evaluating the correlation between METTL27 expression and clinical prognosis. The expression level of METTL27 was further verified in colorectal cancer cell lines and 16 clinical specimens of colorectal cancer tissues using qPCR and Western blotting.@*RESULTS@#METTL27 was highly expressed in 21 cancers, and its expression was significantly higher in colon cancer than in adjacent tissues (P < 0.001). METTL27-related genes were identified by differential analysis, and functional annotation revealed that METTL27 was significantly enriched in transmembrane transport and lipid metabolism, and 5 related signaling pathways were identified by GSEA. METTL27 expression was negatively correlated with different T helper cells and central memory T cells (P < 0.001). The patients with a high METTL27 mRNA expression had a poor survival outcome. Cox regression analysis showed that METTL27 expression was an independent prognostic factor of the overall survival. The expression level of METTL27 was significantly higher in the colorectal cancer cell line than in normal cells (P < 0.05).@*CONCLUSION@#METTL27 is overexpressed in colon cancer and is associated with a poor prognosis of the patients. A high expression of METTL27 showed is associated less T cell immune infiltration, suggesting the potential of METTL27 as a prognostic marker of colon cancer.
Sujets)
Humains , Tumeurs du côlon/anatomopathologie , Estimation de Kaplan-Meier , Pronostic , ARN messagerRésumé
Objective To analyze the clinical characteristics and prognostic risk factors of helicobacter pylori (Hp) infected patients under 30 years old, and to provide a theoretical basis for the eradication of Hp in young Hp-positive patients under 30 years old. Methods A total of 565 patients with upper gastrointestinal symptoms admitted to our hospital from December 2017 to December 2020 were selected. All patients were Hp positive, and all patients were treated with quadruple eradication therapy of Helicobacter pylori. According to the Hp negative status after treatment, the patients were divided into good prognosis group (Hp negative, n=374) and poor prognosis group (Hp not negative, n=191). A self-made questionnaire was used to analyze the age, gender, familial history of gastrointestinal diseases, life habits (long-term smoking, and drinking), eating habits (irregular diet, and excitant food), DOB baseline value, and treatment compliance of the two groups. Logistic regression was used to analyze the factors that may affect the prognosis of HP positive patients. Results Among the 565 Hp positive patients, 347 were males and 218 were females, with an average age of (23.49±4.29) years, 393 (69.56%) aged 18-24 years old and 172 (30.44%) aged 25-29 years old. The diagnosis results of upper gastrointestinal diseases were 54 cases of gastric cancer (9.56%), 229 cases of peptic ulcer (40.53%), 174 cases of chronic gastritis (30.80%), and 108 cases of reflux esophagitis (19.12%). There were no significant differences in age, sex, family history of gastrointestinal diseases and alcoholism between the two groups (P>0.05). There were statistically significant differences between the two groups in long-term smoking, irregular diet, preference for stimulating food, treatment compliance and baseline value of DOB (P<0.05). The results of logistic regression analysis showed that long-term smoking, poor treatment compliance and high DOB value were independent risk factors affecting the prognosis of Hp positive patients (P<0.05). Conclusion Chronic gastritis and peptic ulcer are the main upper gastrointestinal diseases in Hp-positive young patients under 30 years old. Long-term smoking, poor treatment compliance and high DOB value are independent risk factors affecting the prognosis of patients. Treatment compliance of patients should be improved, and intervention should be strengthened in patients with high DOB value and smoking.
Résumé
Objective:To study the clinical prognosis and related factors affecting optimal medical therapy (OMT) compliance of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).Methods:A prospective study was conducted to select 3 818 patients who were diagnosed with CAD and successfully underwent PCI in TEDA International Cardiovascular Hospital from October 2016 to September 2017. The clinical information and application of OMT during hospitalization and 1 year later were collected for research.The patients were divided into OMT group and non OMT group according to whether they adhered to OMT during follow-up one year after discharge. After comparing the imbalance baseline data of hypertension,diabetes and hyperlipidemia with propensity score,demographic characteristics, coronary revascularization history, CAD, laboratory related laboratory examinations,and the use of OMT drugs were compared between the two groups. Cox regression model was used to analyze the relationship between long-term OMT and clinical prognosis in patients with CAD.Multivariate binary logistic regression was used to analyze the related factors affecting long-term OMT compliance.Results:A total of 3 818 cases of CAD patients were matched by propensity score and 2 596 patients were included in the study. There were 1 609 males and 987 females. The age was (62.51±9.56) years old.One year later,1298 patients (50%) insisted on OMT,including dual antiplatelet therapy(DAPT), statins, β-blockers and ACEI/ARB were 97.0% (2 517/2 596),94.5%(2 454/2 596),69.6% (1 806/2 596) and 64.2% (1 666/2 596), especially angiotensin converting enzyme inhibitors / angiotensin receptor blockers and β Receptor blockers decreased the most.Cox regression analysis showed that after adjusting for other factors, compared with non-adherence to OMT group,OMT after PCI was associated with better prognosis ( HR=0.416,95% CI 0.270-0.641, P<0.001). The prognosis of CAD patients with history of old myocardial infarction ( HR=1.804,95% CI 1.070-3.041, P=0.027),cardiac insufficiency ( HR=2.074,95% CI 1.161-3.702, P=0.014),multivessel coronary disease ( HR=2.211,95% CI 1.228-3.983, P=0.008) and BMI>24 ( HR=1.570,95% CI 1.037-2.377, P=0.033) were related to worse clinical outcomes. Multi-factor binary Logistic regression showed that OMT at hospitalization was a strong influencing factor of long-term adherence to OMT ( OR=41.278,95% CI 29.961-56.871, P<0.001). Patients with higher education,employee medical insurance and with history of PCI tend to persist in OMT. Conclusion:The medication compliance of patients with long-term OMT after PCI is still poor,while the high compliance of OMT is related to the lower incidence of adverse cardiovascular events,including death, nonfatal myocardial infarction and stroke. If there is no obvious contraindication,all patients after PCI should adhere to OMT.
Résumé
Objective To investigate the relationship between the expression level of 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and clinical prognosis of liver transplantation for hepatocellular carcinoma. Methods The clinical data of 94 recipients undergoing liver transplantation for hepatocellular carcinoma were retrospectively analyzed. The expression of 15-PGDH in the pathological tissues of all recipients was detected by immunohistochemical staining. The relationship between the expression level of 15-PGDH protein and clinical parameters of hepatocellular carcinoma patients was analyzed. The 5-year tumor-free survival and overall survival rates of liver transplant recipients were calculated. The possible independent risk factors of the clinical prognosis of liver transplant recipients were analyzed. Results The expression level of 15-PGDH was significantly correlated with age, Child-Pugh grade and preoperative level of alpha-fetoprotein (AFP) of the recipients (all P < 0.05). The tumor-free survival and overall survival rates of the recipients with low expression of 15-PGDH were significantly lower than those in their counterparts with high expression of 15-PGDH (both P < 0.05). The expression level of 15-PGDH, degree of tumor differentiation and American Joint Committee on Cancer (AJCC) staging were the independent risk factors of clinical prognosis of liver transplantation for hepatocellular carcinoma (all P < 0.05). Conclusions The expression level of 15-PGDH is an independent risk factor of clinical prognosis of liver transplantation for hepatocellular carcinoma.
Résumé
Objective@#To explore the efficacy of valvuloplasty on mitral valve regurgitation (MR) in infants and small children, in order to provide evidence for clinical treatment.@*Methods@#Retrospective analysis was conducted in patients aged less than 3 years old who have undergone mitral repair surgeries at Department of Cardiovascular Surgery, General Hospital of Western Theater Command from January 2015 to December 2017.Cardiopulmonary bypass (CPB) surgery was performed under general anesthesia.The corresponding repair operations were selected for various MR types.All the children were examined by cardiac ultrasound before discharge.Patients were followed up after surgery and mitral regurgitation was recorded.@*Results@#A total of 69 patients were enrolled, including 30 boys and 39 girls, with an average age of (19.3±11.6) months and an average weight of (9.6±2.1) kg.There were 32 cases of Carpentier type Ⅰ, 30 cases of type Ⅱ and 7 cases of type Ⅲ.Twenty-nine patients were diagnosed as simple MR, while the other 40 patients were combined with other cardiac malformations.One patient died at postoperative day 7.One patient still had severe MR after surgery, and then second operation was performed on the 10th day after first surgery.Sixty-five patients were followed up from 1 month to 3 years[(15.9±10.9) months]. During the follow-up period, no patient died or had reoperation.Aggravated MR was observed in 4 patients.@*Conclusions@#Mitral valvuloplasty is a safe and effective surgical method for treating infants and younger children with MR.The key to the success of surgery is to choose the appropriate individualized repair operation.At the same time, the growth potential of mitral valve should be fully considered to avoid restrained development.
Résumé
Objective To explore the efficacy of valvuloplasty on mitral valve regurgitation (MR) in infants and small children,in order to provide evidence for clinical treatment.Methods Retrospective analysis was conducted in patients aged less than 3 years old who have undergone mitral repair surgeries at Department of Cardiovascular Surgery,General Hospital of Western Theater Command from January 2015 to December 2017.Cardiopulmonary bypass (CPB) surgery was performed under general anesthesia.The corresponding repair operations were selected for various MR types.All the children were examined by cardiac ultrasound before discharge.Patients were followed up after surgery and mitral regurgitation was recorded.Results A total of 69 patients were enrolled,including 30 boys and 39 girls,with an average age of (19.3 ± 11.6) months and an average weight of (9.6 ±2.1) kg.There were 32 cases of Carpentier type Ⅰ,30 cases of type Ⅱ and 7 cases of type Ⅲ.Twenty-nine patients were diagnosed as simple MR,while the other 40 patients were combined with other cardiac malformations.One patient died at postoperative day 7.One patient still had severe MR after surgery,and then second operation was performed on the 10th day after first surgery.Sixty-five patients were followed up from 1 month to 3 years[(15.9 ± 10.9) months].During the follow-up period,no patient died or had reoperation.Aggravated MR was observed in 4 patients.Conclusions Mitral valvuloplasty is a safe and effective surgical method for treating infants and younger children with MR.The key to the success of surgery is to choose the appropriate individualized repair operation.At the same time,the growth potential of mitral valve should be fully considered to avoid restrained development.
Résumé
Objective To investigate the 25-hydroxy-vitamin D[25(OH)D] and vitamin D binding protein ( VBDP) levels in critically ill children admitted to PICU,their clinical significance and the relation-ship with prognosis. Methods Two hundred and ninty-five children with critical illness admitted to PICU from February 2015 to July 2016 were enrolled as subjects( study group) and 44 healthy controls were recrui-ted. Serum 25(OH)D and VDBP levels were measured on the 1st and 7th day of PICU,then clinical data were collected for statistical analysis. Results (1) Among subjects,there were no statistically significant differ-ences in the incidences of 25(OH)D deficiency and VDBP decline(P>0. 05). (2)The levels of 25 (OH)D and VDBP in the study group were lower than those in the control group [ ( 61. 38 ± 29. 42 ) nmol/L vs. (97. 11 ± 30. 11) nmol/L; (514. 36 ± 211. 13)μmol/L vs. (840. 82 ± 448. 96)μmol/L,respectively,P <0. 05]. (3) There were no significant differences in the level of VDBP ,28-day mortality,organ failure rate and mechanical ventilation rate among 25(OH)D adequate group(n=85),inadequate group(n=97) and deficient group( n=113 ) ( P>0. 05 ) . The duration of PICU stay,PRISMⅢscores were significantly longer and higher (P<0. 05) in 25(OH)D inadequate group or deficient group than those of 25(OH)D adequate group.(4) Compare to the 7th day ,the levels of 25(OH)D and VDBP were lower (P <0.05) and PRISM Ⅲscores was higer on the 1st day in the cases staying in PICU≥7 d[ (71. 14 ± 31. 78)nmol/L vs. (60.65 ±30.77)nmol/L;(532.23 ±148.49)μmol/L vs. (484.73 ±128.17)μmol/L;2.0(0.0 ～5.0) scores vs. 5. 0(3. 0～8. 0)scores,respectively,P<0. 05]. (5) Among the 295 cases of critically ill children ,the 28-day mortality was 12. 9％(38/295),the death patients showed lower 25(OH)D status[ (51. 17 ± 29.65)nmol/L vs. (62.89 ±29.15)nmol/L,P <0.05] and higher PRISM Ⅲ score[ 8.5(5.0 ～14.3) scores vs. 4. 0(1. 0～7. 0) scores,P<0. 05 ]than those of the survival. Conclusion (1)The prevalences of 25(OH)D and VDBP insufficient and deficiency among critically ill children are high. (2) Patients with 25(OH)D insufficiency and deficiency show a poorer prognosis than those with sufficient 25(OH)D. (3) The change of 25(OH)D status is not completely consistent with the VDBP.
Résumé
Objective To evaluate the effects of different energy feeding on the nutritional status, clinical course and outcome of children with congenital heart disease(CHD) in PICU.Methods Forty cases of hospitalized CHD children were selected as research objects from July 1,2016 to February 28,2017.They were randomly divided into two groups,one group(high-calorie milk group,n=20) were fed with high-calo-rie milk and the other(common milk group,n=20)were fed with common milk.The nutritional status of the two groups were calculated by physical measurements, laboratory indicators, nutrition risk screening and resting energy expenditure.This research also calculated the liquid and energy per day,compared their actual feeding situation,assessed their nutritional status and cardiac function at discharge,and compared the hospi-tal stay,preoperative and postoperative mechanical ventilation time and postoperative fever time.Results There was no statistical difference in the assessment of malnutrition during the discharge of high-calorie milk group.In common milk group,the proportion of moderate to severe malnutrition of discharge was significantly higher than that of admission(χ2=2.537,P=0.042).The proportion of moderate to severe malnutrition was great higher in common milk group than that in high-calorie milk group,but there was no statistical difference, and neither in nutritional risk screening nor cardiac function between the two groups at discharge.Albumin and transferrin of high-calorie milk group were significantly higher than those of the common milk group(t =2.195,P=0.034;t=2.064,P=0.046).Also the number of appropriate energy supply and feeding cases in the high-calorie group were higher than those in the common milk group(t=2.334,P=0.025;χ2=10.600,P=0.005).Nine cases underwent cardiopulmonary operation in the two groups respectively.There was no statisti-cal difference in the time of ventilatory support between the two groups before and after operation, but the fever time of high-calorie milk group was significantly lower than that of the common milk group(t=2.439, P=0.027).Conclusion The incidence of malnutrition and undernourishment of children with CHD is high, and the incidence of nutrition risk is high,therefore increasing energy supply of children with CHD without in-creasing the heart load could improve their nutrition status and clinical outcome.
Résumé
Objective To investigate the impact of high mobility group box1 and GRACE score on the clinical prognosis of patients with acute coronary syndrome undergoing selective percutaneous coronary intervention. Methods A total of 380 consecutive patients initially diagnosed with acute coronary syndrome undergoing selec-tive PCI between January 2014 and March 2015 were included,with 200 of them assigned into low high mobility group box1(HMGB1<445 ng/mL)and the other 180 patients into high mobility group box1(HMGB1≥445 ng/mL).The baseline characteristics and laboratory indexes were collected on admission,GRACE score were calculat-ed at admission.The difference between the high and low high mobility group box1 were analzyed and the influenc-ing factors of patients with acute coronary syndrome undergoing selective percutaneous coronary intervention were studied. The mean follow-up period was 24 months,and the clinical end points were deaths from various causes and readmission for coronary heart disease. Results There were significantly differences statistically between the groups of high and low high mobility group box1 in clinical diagnosis. lipoprotein associated phospholipase A2, GRACE score,mean platelet volume,red cell distribution width,age,and left ventricular ejection fraction(P <0.05). The correlation analysis showed that HMGB1 was significantly related to lipoprotein associated phospholi-pase A2 and GRACE score,with the correlation coefficents of 0.575,0.836,respectively(P<0.05).COX analy-sis showed that HMGB1,lipoprotein associated phospholipase A2,GRACE score had statistical significance for survival outcomes(P<0.05),and the area under the ROC curve drawn by combining the three was 0.851(95% CI 0.811 ~ 0.891,P < 0.05). Conclusion There was a good correlation between HMGB1 and GRACE score. HMGB1 is a good predictor of clinical outcomes in the patients with acute coronary syndromes undergoing elective PCI treatment.
Résumé
Objective: To investigate the effects of preoperative sarcopenia on postoperative clinical outcome in patients with gastric cancer. Methods: A prospective study was performed in 93 patients with gastric cancer and the skeletal muscle mass was examined by bioelectrical impedance. The primary outcome was postoperative complications. The secondary outcomes were postoperative length of stay, overall hospital costs, 60 days re-admission and mortality rate. Results: A significant difference (sarcopenia group vs. non-sarcopenia group) was observed in the rates of overall postoperative complications, incidence of pleural effusion and intra-abdominal infection, overall hospital stay and postoperative hospital stay (P ＜ 0. 05). The rates of 60 days readmission, 60 days mortality and hospital costs in sarcopenia group were not different between the two groups (P ＞ 0. 05). By univariate and multivariate analysis, preoperative sarcopenia and preoperative nutritional risk are the risk factors of postoperative complications. Conclusion: Sarcopenia is an independent risk factor for postoperative complications in patients with gastric cancer; preoperative patients with sarcopenia have a worse prognosis and should be screened and optimized before surgery.
Résumé
Objective:To investigate the role of transforming growth factor β1 (TGF-β1) in multi-drug resistance in small cell lung cancer and its clinical significance.Methods:The mRNA and protein expressions of TGF-β 1 in H69 and H69AR cells were detected by real-time PCR and Western blot,respectively.After silence of TGF-[β1,the sensitivity of H69AR to drugs was detected by CCK8 assay.The expressions of TGF-β1 in lung cancer and paracarcinoma tissues were examined by QRT-PCR and immunohistochemistry.The relationship of TGF-β 1 expression with clinical pathological features and prognosis of patients was studied.Results:Compared to H69,the mRNA and protein expressions of TGF-β1 in H69AR cells were significantly increased by (5.93±0.47) and (8.49±1.92) folds,respectively (P＜0.01).Transfection ofTGF-β1 siRNA resulted in a decrease of TGF-β1 expression by 70.432％ in H69AR ceils (F=21.20,P＜0.01) and an increase insensitivity to chemotherapeutic agents of H69AR cells (t=4.576,P＜0.05).Compare with the paracarcinoma tissues,the expression of TGF-β1 was significantly increased in small cell lung cancer tissues (t=13.925,P＜0.01),which was closely related with clinical stage,chemosensitivity and overall survival (all P＜0.05),but not related with gender,age (both P＞0.05).Conclusion:TGF-β1 is involved in the regulation of small cell lung cancer multidrug resistance,which may be a potential marker to evaluate the chemosensitivity and dinical prognostic for small cell lung cancer.
Résumé
Objective To explore the expression of P53 ,Livin and PARP in epithelial ovarian cancer and its correlation with the chemotherapy resistance and clinical prognosis.Methods Seventy-four specimens of epithelial ovarian cancer confirmed by opera-tion and pathology in the gynecology department of our hospital from January 2009 to June 2011 were selected ,followed up and di-vided into chemotherapy sensitivity group and chemotherapy resistance group according to the recurrence condition.The difference of drug resistance genes ,survival rate and influencing factors of survival time were compared between the two groups.Results The positive rates of P53 ,Livin and PARP in the chemotherapy sensitivity group were 47.1% ,56.9% and 52.9% respectively ,which in the chemotherapy resistance group were 73.9% ,95.7% and 95.7% respectively ,the sensitivity rate of each item in the chemother-apy sensitivity group was lower than that in the chemotherapy resistance group (P<0.05).The median survival time in the survival rate in the chemotherapy sensitivity group was 52.0 months ,its 3-year and 5-year survival rates were 68.63% and 41.18% respec-tively ,the medium survival time in the chemotherapy resistance group was 31.5 months ,its 3-year and 5-year survival rates were 47.83% and 26.10% respectively ,the survival rate of various stages in the chemotherapy sensitivity group was higher than that in the chemotherapyresistance group ,the difference was statistically significant (P< 0.05).The age ,pathological differentiation de-gree ,clinical staging and chemotherapy sensitivity degree were introduced into the Cox regression model ,the clinical staging and chemotherapy sensitivity degree had significant influence on the survival time (P<0.05).Conclusion The expression of P53 ,Livin and PARP is correlated with the chemotherapy resistance in the patients with epithelial ovarian cancer ,therefore ,which can be used to predict the chemotherapeutic effect.For the patients with high expression of drug resistance genes ,the personalized coping scheme may be given for improving the patient's prognosis.
Résumé
Objective To investigate the risk factors associated with clinical prognosis of cervical cancer treated with laparoscopic surgery. Methods 80 patients with cervical cancer were recruited in the study, who underwent radical surgery with laparoscopic surgery from March 2013 to December 2016. The patients were followed up after surgery, and the overall survival and disease free survival was analyzed with tumor recurrence and death as the terminal events. And the risk factors associated with clinical prognosis were identified by using Cox regression analysis. Results The patients were followed up from 12 months to 46 months, and the median period was 39 months. There were 16 recurrences and 6 deaths during the period of follow-up, yielding a disease-free survival of (41.85 ± 1.06) year and an overall survival of (44.86 ± 0.74) year. Cox regression analysis demonstrated that tumor size, clinical stage, lymph node metastasis and vascular invasion were independent risk factors associated with clinical prognosis of cervical cancer treated with laparoscopic surgery. Conclusion Tumor size, clinical stage, lymph node metastasis and vascular invasion were independent risk factors associated with clinical prognosis of cervical cancer treated with laparoscopic surgery.
Résumé
Objective To explore the efficacy and safety of Solitaire stents and the multi-mode vascular recanalization in the treatment of acute cerebral infarction. Methods Twenty-two patients with acute cerebral infarction, who were treated by Solitaire stents and the multi-mode vascular recanalization (research group) in our hospital from November 2014 to February 2017, were included in this study. Among them, 16 cases were combined with balloon dilation after arterial thrombosis, 4 cases were given stent implantation (3 cases were given Solitair stent and 1 case was given Apollo stent), and 2 cases were given arterial catheter directed thrombolysis. Eighteen patients with acute cerebral infarction who were treated only by Solitaire stent artery occlusion from October 2011 to October 2014 were used as control group. Data of the onset to the vagina vasorum time, the onset to the recanalization time, the revascularization of interventional therapy, the NIHSS scores at admission and discharge, mRS score after 90-day treatment, incidence rate and the mortality were compared between two groups. Results There were no significant differences in the durations from onset to the vagina vasorum and from the onset to the recanalization between the two groups. The recanalization was better in research group than that of control group (P<0.05). There were no significant differences in scores of NIHSS at hospital discharge and admission between two groups. The near-term treatment efficacy was similar in two groups. However, mRS score was significantly lower in the research group than that in control group after 90-day treatment (P<0.05). There were no significant differences in the symptomatic intracranial hemorrhage, high perfusion encephalopathy, the incidence rate and the mortality rate of the complications related to the operation between two groups of patients. Conclusion Solitaire stents and the multi-mode vascular recanalization can significantly improve the revascularization, the further clinical prognosis and the quality of survival in patients with acute cerebral infarction, which are safe and efficacy without increasing incidence rate and mortality rate of complications.