Methodological study and clinical value of serum exosome Annexin A11 in pancreatic cancer / 中华检验医学杂志

Objective:To explore a method for detecting recombinant human Annexin A11 (ANXA11) in serum exosomes of pancreatic cancer patients, and then primarily evaluate the clinical value of ANXA11 in pancreatic cancer patients.Methods:A prospective study was conducted and serum specimens from 70 patients diagnosed with PC, 15 patients diagnosed with benign pancreatic mass and 70 patients diagnosed with pancreatitis from the Affiliated Hospital of Nantong University were collected from December 2016 to July 2019. 70 healthy subjects during the same period were selected as control group. The abundance of ANXA11 in serum and exosomes-free serum were detected through parallel reaction monitoring (PRM) basing on high-resolution, high-precision mass spectrometer. Dot immunoblotting created by ourselves for detecting ANXA11 in exosomes and then the methodological evaluation were carried out. Levels of ANXA11 in exosomes in all subjects were statistically analyzed. Moreover, the areas under the curve (AUC) of receiver operating characteristic (ROC) curves were adopted to evaluate the diagnostic efficacy of ANXA11, CA19-9, CEA on PC. The relationship between ANXA11 and clinicopathological parameters as well as prognosis of PC patients was analyzed in the next moment. For analysis, the Mann-Whitney U test was used for comparing between either two groups, and the kruskal-wallis test was used for comparison among four groups. Results:The detection of serum exosome ANXA11 has high sensitivity and repeatability by the method of self-established dot immunoblotting. ANXA11 increased most significantly in the PC group, and the difference was statistically significant ( Hc=58.079, P<0.01) compared with other three groups. ROC curve analysis showed that the diagnostic performance of ANXA11(area under the curve (AUC=0.836) was higher than CEA (AUC=0.656) and equal to CA19-9 (AUC=0.870). The combination of ANXA11 and CA19-9 could improve the sensitivity of diagnosing PC and maintain good specificity. The level of serum exosome ANXA11 before treatment in PC patients was not related to age, gender, tumor size, tumor growth site, lymph node metastasis, distant metastasis and TNM stage ( Z values are 0.052,-0.285,-0.402,0.324,0.888,0.658,1.734, P>0.05). Furthermore, during the 10th day after surgical treatment, the level of ANXA11 showed no statistical difference compared with that before surgery ( Z value is -1.569, P=0.12). The survival time of PC patients was related to the presence of lymph node metastasis, distant metastasis, TNM staging and treatment protocols (χ 2 values are 9.354,6.086,9.389,16.998, P<0.05), while had no correlation with levels of CEA, CA19-9 and ANXA11 (χ 2 values are 1.516, 0.011, 0.159, P>0.05). Conclusions:This study successfully established an original method for detecting ANXA11 levels in serum exosomes of human. Serum exosomes ANXA11 combined with CA19-9 could improve the diagnostic sensitivity of PC.

Clinical value of multiplex PCR in the diagnosis of secondary infection of severe acutep ancreatitis / 中华胰腺病杂志

Objective To investigate the diagnostic value of multiplex polymerase chain reaction (m-PCR) for diagnosing second infection of severe acute pancreatitis ( SAP), and to provide evidence for anti-infection treatment of SAP .Methods From January 2011 to December 2014 , thirty five patients of SAP were enrolled .Seven to fourteen days after SAP onset , patients′blood samples were taken and the presence of infection was determined by mP-CR.In the meantime, peripheral blood or the paracentesis fluid was cultured , and the result of culture was regard as golden standard to diagnose infection .Rseults The m-PCR could simultaneously detect 9 kinds of intestinal resident pathogenic bacteria , and the lower limit of detection was 10~1 000 copies.The detection rates were as follows (cultivation vs. m-PCR):staphylococcus aureus 6 vs 5 cases, staphylococcus epidermidis 11 vs 9 cases, enterococcus faecalis 2 vs 3 cases, enterococcus faecium 6 vs 7 cases, escherichia coli 19 vs 17 cases, klebsiella pneumoniae 2 vs 3 cases, pseudomonas aeruginosa 6 vs 4 cases, acinetobacter baumannii 2 vs 2 cases, malt narrow food aeromonas 4 vs2 cases.The 7th~14th days after SAP onset, the blood or paracentesis fluid culture was positive in 27 patients,and negative in 8 cases. And the m-PCR results were positive in 30 patients, and negative in 8 cases.The m-PCR results were positive in 30 patients, negative in 5 patients.The m-PCR results were positive in 3 patients who had negative culture results.In the remaining 32 cases, the results were consistent between the two detection methods .When the culture result was regarded as golden standard , the sensitivity, specificity and accuracy of m-PCR were 100%, 62.5%and 91.43%, respectively.The positive predictive value and the negative predictive value were 90%and 100%, respectively.It took (26 ±15) hours on average to obtain the result of culture method , and it took (102 ±32) hours on average to obtain the confirmative results .It took (12 ±8) hours on average to obtain the result of the m-PCR method.The time course of m-PCRwas significantly shorter than that of the traditional culture method, and the difference was statistically significant (P<0.05).Conclusions The m-PCR method can be used to monitor the bacterial infection in patients with SAP .The m-PCR method is a highly sensitive and rapid detection approach , which is worth of clinical application .

Posterior Decompression and Lumbar Interbody Fusion with Internal Fixation Treating Degenerative Lumbar Scoliosis / 天津医药

Objective To assess the clinical outcomes of posterior decompression and lumbar interbody fusion with internal fixation treatment for degenerative lumbar scoliosis (DLS). Methods Ninety-eight patients underwent surgery for DLS were retrospectively reviewed in this study. The mean age of the patients(male 35 and femail 63) was (56±9) years. The mean Cobb angle of curves was (26±9)° and the mean scoliosis Cobb angle of lumbar was (19±11)° in patients before surgery. A posterior medial incision was made for spinal exposure. According to the preoperative plan, patients were operated with posterior de-compression and lumbar interbody fusion with internal fixation. The clinical outcomes were assessed by the JOA scores.The preoperative and postoperative Cobb angle was recorded. Results The mean follow-up time was (3.7±2.4) years. The mean JOA scores were improved from (10±2) points preoperatively to (26±3) points at the last follow-up. The excellent or good outcome rates were 89.7%for patients with surgery. The average interbody fusion time was (5.7±1.4) months. The mean postoperative Cobb angle was (6±2)° at the last follow-up, and the mean Cobb angle correction was (17±4)°, with the correction rate of 59.2%. The mean lumbar lordosis angle was (12±3)°. There was no failure in internal fixation. Conclusion The posterior decompression and lumbar interbody fusion with internal fixation appears to be a reasonable option for degenerative lumbar scoliosis.

The application of mosapride combined with polyethylene glycol electrolyte powder in preparations for colonoscopy in patients with constipation / 中国医师进修杂志

Objective To explore the effect of mosapride combined with polyethylene glycol electrolyte powder on cleaning intestinal tract before colonoscopy in patients with chronic constipation.Methods A total of 127 patients with chronic constipation for colonoscopy were randomly divided into observation group of 64 cases,oral administration of mosapride 10 mg and polyethylene glycol electrolyte powder; control group of 63 cases,oral polyethylene glycol electrolyte powder for bowel preparation for colonoscopy.The intestinal cleanness,first defecation time and adverse reaction was compared between two groups.Results The Boston bowel preparation score was (8.32 ± 0.86) scores in observation group,and (7.69 ± 0.95) scores in control group,and there was significant difference between two groups (t =3.918,P＜ 0.05).The first defecation time after taking the medicine was (45.69 ± 13.57) min in observation group and (54.63 ± 11.78) min in control group,and there was significant difference between two groups (t =3.966,P ＜ 0.05).After taking the medicine,5 cases of nausea and vomiting and 11 cases of abdominal distension in observation group,13 patients of nausea and vomiting and 23 cases of abdominal distension in control group,and there was significant difference between two groups (x 2 =4.29,6.04,P ＜0.05).Conclusion Mosapride combined with polyethylene glycol electrolyte powder can improve the intestinal tract cleaning quality,shorten the time of first defecation time,and reduce adverse reaction.

Eradication of Helicobacter pylori with levofloxacin-containing sequential therapy / 中国综合临床

ObjectiveTo observe the efficacy of a Levofloxacin-containing 10-day sequential therapy for Helicobacter pylori eradication.Methods Totally 86 Helicobacter pylori-infected patients with chronic gastritis or peptic ulcer diagnosed by gastroscopy were randomized into two groups: the trial group and the control group (n =43 in each group).The trial group was treated with Esomeprazole 20 mg bid plus Amoxicillin 1000 mg bid at the first 5 days,and followed by Esomeprazole 20 mg bid,Levofloxacin 500 mg qd and Furazolidone 100 mg bid,at the last 5 days;The control group was treated with standard triple regimen: Esomeprazole 20 mg,Amoxicillin 1000 mg and Clarithromycin 500 mg,all bid for 7 days.The eradication rates of Helicobacter pylori in the two groups were compared after completion of treatment.ResultsAfter treatment,the eradication rates of Helicobacter pylori were significantly different between the trial and control group(93.0％ vs 74.4％,P ＜0.05)Conclusion The 10-day sequential therapy with.Levofloxacin-containing regime can achieve a higher eradication rate of Helicobacter pylori infection.