Clinical predictive value of TCD in monitoring cerebral circulation in sepsis patients / 中华急诊医学杂志

Objective:To study the dynamic evaluation value of transcranial Doppler (TCD) in cerebral circulation and brain function of sepsis patients and its predictive value of the prognosis.Methods:A retrospective analysis was performed on 98 sepsis patients admitted to our hospital from January 2017 to June 2018 who were divided into the survival group (56 cases) and death group (42 cases) according to the 28-day prognosis. The general clinical data of the patients, acute physiology and chronic health evaluation II (APACHE II), delirium assessment scale (CAM-ICU), and TCD parameters PSV, Vm, EDV, PI, RI on the first day and the third day of admission were collected, and the differences of TCD parameters at different time points were analyzed between the two groups, the area under the ROC curve (AUC) was calculated and evaluating their predictive value of sepsis outcome was evaluated.Results:APACHE Ⅱscore and the number of patients with sepsis encephalopathy were significantly higher in the death group than those in the survival group ( P < 0.05). There were no significant differences in PSV, Vm and EDV between the two groups on the first day and the third day. The PI and RI of the survival group were significantly lower than those of the death group ( P<0.01). In the survival group, PI and RI on the third day decreased significantly compared with those on the first day ( P < 0.05), while in the death group, PI and RI on the first day and the third day did not change significantly. ROC survival curves showed that Day1PI, Day3PI, Day1PI - Day3PI, Day1RI, Day3RI, Day1RI - Day3RI and APACHEⅡ predicted AUC of the prognosis of sepsis patients were 0.657, 0.835, 0.730, 0.707, 0.826, 0.705, and 0.815 ( P < 0.01). When PI cutoff value on the third day became 1.02, the sensitivity was 85.7% and the specificity was 61.3%. When RI cutoff value on the third day became 0.62, the sensitivity was 78.6% and the specificity was 71.4%. Conclusions:TCD parameters, PI and RI, are of certain value in the dynamic evaluation of cerebral circulation and brain function in sepsis patients. PI and RI on the first day and the third day and the differences between them are all valuable in predicting the prognosis, and PI and RI on the third day have greater predictive value.

Research on effects of nursing intervention on enhancement of colonoscopy compliance of colorectal cancer high-risk population / 中国实用护理杂志

Objective To discuss the effects of nursing intervention under the guidance of health belief on enteroscopy compliance of colorectal cancer high-risk population. Methods A total of 260 people, who were clearly identified as colorectal cancer high-risk population during preliminary screening of 2 communities in Nankai District, Tianjin but had not finished enteroscopy, were selected and divided them into intervention group and control group with 130 people per group by random digits table method. In the intervention group, subjects received nursing intervention with guidance of the health belief model for a year, while in the control group, subjects simply received regular propaganda and education about colorectal cancer screening. Results After intervention, the cognitive levels in colorectal cancer screening, enteroscopy screening, high-risk factors was (9.16±2.95), (14.55±3.41), (14.25±4.26) points in intervention group and (7.28 ± 3.26), (12.23 ± 3.72), (13.12 ± 4.11) points in control group, and there was significant difference between two groups (t=4.855, 5.228, 2.180, P<0.01 or 0.05). After intervention, the scores of health belief including susceptibility, benefits, barriers, self-efficacy was (7.74 ± 1.50), (13.20 ± 2.45), (6.59 ± 1.91), (23.54±3.16) points in intervention group, and (6.68 ± 1.47), (11.58 ± 2.15), (8.42 ± 1.99), (20.82 ± 3.02) points in control group, and there was significant difference between two groups(t=5.730, 5.682,-7.561, 7.096, P<0.01). The rate of enteroscopy screening was 20.47%(26/127) in intervention group and 8.87%(11/124) in control group, and there was significant difference between two groups(χ2=6.719, P<0.05). Conclusions The nursing intervention under the guidance of health belief helps colorectal cancer high-risk population establish health belief, enhances participation rates of colonoscopy screening and has important significance to positive rates of early colorectal cancer.

Clinical application of T cell enzyme-linked immunospot assay in extrapulmonary on rapidly diagnosis of patients with tuberculosis / 中国综合临床

Objective To investigate the diagnostic value of T cell enzyme-linked immunospot (T-SPOT.TB) assay on extrapulmonary tuberculosis patients.Methods Thirty patients suffered from extrapulmonary mycobacterium tuberculosis(MTB) infection and 30 with non-MTB infection were recruited this study.T-SPOT.TB assay was used to detect early secreting antigen target-6 (ESAT-6) and culture filtrate protein-10(CFP-10) specific T cells in blood samples.PPD skin test was also used.Results (1)The positive rate of MTB detected by T-SPOT.TB assay was 91.89％ (34/37),higher than that of un-tuberculosis group (6.67 ％ (2/30)),and the difference was significant (x2 =48.403,P ＜ 0.001).(2) The sensitivity,specificity,positive prospective value and negative prospective value of T-SPOT.TB assay were 91.89％,93.33％,94.44％ and 90.32％ respectively,better than those of PPD skin test (67.57％,56.67％,65.79％,58.62％),and the differences were markedly (x2 =6.773,10.756,9.392,8.031 respectively ; P =0.009,0.001,0.002,0.005 respectively).Meanwhile T-SPOT.TB assay has low agreement with means of PPD skin test(Kappa =0.311,x2 =6.801,P =0.009).Conclusion T-SPOT.TB assay has a higher sensitivity and specificity in the rapid diagnosis of extrapulmonary tuberculosis.Therefore,it is with great value and applicability as a screening test.

Silencing IDH-2 gene by siRNA-IDH-2 inhibits human small cell lung car-cinoma growth / 中国病理生理杂志

[ABSTRACT]AIM:Toinvestigatetheeffectofsilencingisocitratedehydrogenase2(IDH-2)genebysmallinter-fering RNA (siRNA) on the biological characteristics of human small cell lung cancer cell line NCI -H446.METHODS:IDH-2 expression was knocked down in human small cell lung cancer cell line NCI -H446 by siRNA-IDH-2.The expression level of IDH-2 was determined by real-time PCR and Western blotting .The cell proliferation was measured by CCK-8 as-say , the protein expression of MAPK p 42 was detected by Western blotting , and the cell cycle was analyzed by flow cytome-try.The migration was observed using Transwell cell migration system .BALB/c nude mice were subcutaneously injected on the back with NCI-H446 cells transfected with siRNA-IDH-2/negative control siRNA or non-transfected cells to study the tumor growth .RESULTS:siRNA-IDH-2 remarkably down-regulated the expression of IDH-2 and MAPK p42 in the NCI-H446 cells.siRNA-IDH-2 inhibited both the proliferation and migration abilities of NCI-H446 cells, and the cell cycle was arrested in S phase as compared with negative control group .Additionally, the volume of xenograft tumors in siRNA-IDH-2 group was significantly decreased as compared with control group .CONCLUSION:siRNA-IDH-2 down-regulates the expres-sion of IDH-2 in NCI-H446 cells, reduces the cell migration efficiency and inhibits the tumor growth in vitro and in vivo.

Clinical features of 50 cases of primary gastric lymphoma / 中南大学学报(医学版)

OBJECTIVE@#To analyze the clinical characteristics of primary gastric lymphoma (PGL) and to improve its diagnosis and treatment.@*METHODS@#The clinical manifestations, diagnosis, treatments and history of 50 PGL patients, who were hospitalized from September 2005 to September 2009, were reviewed and analyzed.@*RESULTS@#The main manifestation of PGL was epigastric pain with infrequent systemic symptoms, such as stomach ache, abdominal discomfort, vomit, black stool, loss of appetite, fever, feeble, and skinny. Pathological examination indicated that only 1 patient had T cell lymphoma while the rest 49 had B cell lymphoma. Fourteen had mucosa-associated lymphoid tissue lymphoma (MALT), 35 had diffuse large B cell lymphoma (DLBCL), and 2 had both DLBCL and MALT (DLBCML). All the 50 patients received chemotherapy, and 12 underwent surgical treatment besides chemotherapy. Fourteen out of the 49 patients with B cell lymphoma received rituximab together with chemotherapy, and 35 received chemotherapy alone. The 2-year survival rate in the patients receiving rituximab together with chemotherapy was higher than that in the patients receiving chemotherapy alone (85.7% vs 77.1%, P< 0.05). The 2-year survival rate in patients of clinical stage I-II was higher than that in patients of clinical stage III-IV (90.9% vs 71.4%, P< 0.05).@*CONCLUSION@#The main clinical manifestation of PGL patients is non-specific gastrointestinal symptoms, among which abdominal pain is most common. The clinical examination mainly relies on pathological examinations, and the most common pathological type of primary gastric lymphoma is DLBCL. The main treatment is chemotherapy, and the prognosis is related to the clinical stage and the use of rituximab. After the treatment, the 2-year survival rate in the 50 patients reaches 80.0%.

Transcriptomic regulation and molecular mechanism of polygenic tumor at different stages / 中南大学学报(医学版)

The research team on the National Key Scientific Program of China: "Transcriptomic regulation and molecular mechanism research of polygenic tumor at different stages" has focused on the field of transcriptomics of 4 common polygenic tumors, including nasopharyngeal carcinoma(NPC), breast cancer, colorectal cancer, and glioma. Extensive laboratory work has been carried out on the expression and regulation of tumor transcriptomics; identification of tumor suppressor/susceptible genes; mechanism of tumor epigenetics including miRNAs, and comparative study of specific gene/protein cluster of tumor transcriptomics and proteomics. Genes including SPLUNC1, LTF, BRD7, NOR1, BRCA1/2, PALB2, AF1Q, SOX17, NGX6, SOX7, and LRRC4 have been identified as the key transcriptional regulation genes during the stage of tumor initiation and invasion. Accordingly,the NPC gene signal regulation network of "SPLUNC1-miR-141-target genes", the breast cancer interaction signal pathway of "miR-193b-uPA",the glioma signal network of "miR-381- LRRC4-MEK/ERK/AKT", and the miRNA-target gene network of colorectal cancer metastasis related gene NGX6 have been thoroughly elucidated. These fruitful Results imply that the changes of key molecules in crucial signal pathway will cause severe dysfunction in signal transduction and gene regulation network in polygenic tumors, indicating that in the category of pathogenesis,these tumors may further classify as the "Disease of gene signal transduction and gene regulation network disorder". The researches have laid solid foundation for revealing the molecular mechanism and transcriptomic regulation of polygenic tumors at different stages.

Maintenance of Epstein-Barr virus latent genome in epithelial tumor cells during the cellular clonal expansion / 中南大学学报(医学版)

Objective To determine the maintenance and loss of Epstein-Barr virus (EBV) genome during the clonal expansion of the EBV-infected epithelial cells. Methods The epithelial tumor cell line, 293-EBV, in which the EBV genome was observed with green fluorescent protein (GFP) readout. After a dozen of passages, it contained cells with strong or weak GFP expression, and some with complete loss of EBV genome. The cell growth was then continuously observed under a confocal microscope. The cell dividing and GFP expression were also observed during the clonal expansion by being made into very low density. Results The cells moved around due to adherence and mobility, while the GFP expression remained unchanged in the undivided cells. The cells could form compact or loosen clones. The EBV genome easily persisted in those clones when cells were growing compactly. As the cell number increased, the GFP expression became weak or even died away at the sites of low density in the loosen clones. Conclusion EBV-positive epithelial cells are able to sustain the EBV genome during its clonal expansion. The cells maintain EBV genomes by passing them to the daughter cells after replication. When the cells unsuccessfully inherit the EBV genome, the daughter cells may lose them which is related to the low cell density as well as the epithelial environment.

The value of serum ICTP in the early diagnosis, efficacy and prognosis of tumor bone metastasis / 中国综合临床

Objective To evaluate the serum pyridinoline cross-linked carboxyteminal telopeptide of type Ⅰ collagen ( ICTP) in the early diagnosis potency,efficacy and prognosis of tumor bone metastasis. Methods According to emission computed tomography(ECT) ,MRI and X-ray results,336 cases of tumor were divided into higher ICTP (5. 98 ± 1. 95μg/L ) than normal values. Twenty-two cases were identified bone metastasis through PET/CT examination. 26 cases were identified bone the effective cases decreased from( 13. 22 ± 4.65)μg/L (before treatment) to (7. 18 ±3. 54)μg/L (after treatment) (t = 10. 076,P = 0. 000). Conclusions Serum ICTP is helpful for the early diagnosis, screening and efficacy evaluation of tumor bone metastasis. It could be used for monitoring the occurrence of tumor bone metastasis and its prognosis.