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Objective To explore the influence of negative lymph node count (NLNC) on the prognosis of patients with gastric signet ring cell carcinoma (GSRC) and develop a prognostic nomogram based on NLNC. Methods On the basis of the SEER database, 2 101 patients diagnosed with GSRC were collected and randomly divided into the modeling group and validation group to test the relationship between clinicopathological characteristics and the prognosis of GSRC. The multivariate Cox proportional hazard regression model was used to analyze the independent risk factors affecting overall survival and establish a prognostic prediction model. The consistency index (C-index), calibration curve, net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) were used to evaluate the accuracy and clinical applicability of the nomogram. Results All patients were divided according to the ratio of 7:3, with 1 473 in the modeling group and 628 in the validation group. NLNC > 10 (HR=0.578, 95%CI: 0.504-0.662, P < 0.001) was a protective factor for the prognosis of patients with GSRC, and the nomogram model was established based on multivariate Cox proportional hazards model. The C-index values of the nomogram were 0.737 (95%CI: 0.720-0.753) and 0.724 (95%CI: 0.699-0.749) in the modeling and validation groups, respectively, showing good discrimination. The calibration curves showed high consistency of the model. NRI=17.77%, continuous NRI=36.34%, and IDI=4.2% indicated that the model had positive returns compared with the traditional model. The DCA was far from the baseline, indicating that the model had good clinical applicability. Conclusion The increase in NLNC is a favorable factor for the prognosis of patients with GSRC, and a relatively accurate nomogram was established to predict the prognosis of patients with GSRC and help clinicians conduct individualized prognostic evaluations.
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Objective To investigate the effect of square dance on bone mineral density and osphyarthrosis and gonitis in postmenopausal women.Methods The postmenopausal women who danced on a square in the Second Hospital of Wuxi Mfiliated to Nanjing Medical University from January 2014 to January 2015 were selected and divided into different groups by age.Each group of subjects received the bone mineral density test of their lumbar vertebral body 1-3,so as to analyze the difference between the bone mineral density of each vertebral body and the corresponding age,as well as the relationship between the age and the bone mineral density.The bone mineral density of their lumbar vertebrae was measured one year later,and the incidence rates of osphyarthrosis and gonitis were observed,thus the influence of square dancing on bone mineral density and the incidence of osphyarthrosis and gonitis of postmenopausal women was studied.Results There was statistically significant difference in the bone mineral density for lumbar vertebrae of different age groups (F =74.213,P ＜ 0.01),among which the bone mineral density of lumbar vertebrae 1 ～ 3 in the age group of 45-60 showed a decreasing trend,with a medium negative correlation with age (r =0.978).After dancing on a square for 1 year,the bone mineral density of lumbar vertebral body 1-3 of subjects in the age group of 45-50,the age group of ＞ 50-55,the age group of ＞ 55 ～ 60,the age group of ＞ 60-65,the age group of ＞ 65-70 and the age group of over 70 were (149.51 ± 31.65) mg/cm3,(118.98 ± 34.55) mg/cm3,(103.56 ± 23.44) mg/cm3,(86.88 ± 34.21) mg/cm3,(69.89 ± 29.72) mg/cm3,(61.22 ± 34.21) mg/cm3,respectively,which increased slightly;the bone mineral density of the age group of 45-50,the age group of ＞ 50-55 and the age group of ＞55-60 increased significantly(F =8.012,3.567,4.774,all P ＜0.05).Square dancing had no significant effect on the incidence of osphyarthrosis and gonitis of postmenopausal women.Conclusion The age group of 45-60 is the most obvious period of bone mineral density decline for women.Square dancing can effectively improve the bone mineral density of postmenopausal women in this age group,but has no obvious effect on the improvement of the bone mineral density of women in other age groups.Square dancing has no effect on the incidence of osphyarthrosis and gonitis of postmenopausal women.
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Objective@#To explore the effect of obesity on the treatment for femoral neck fracture in patients with SuperPATH hip replacement.@*Methods@#Seventy patients who were treated with SuperPATH hip replacement in the Second People's Hospital of Wuxi from January 2014 to January 2017 were selected in the study.Based on their body mass index(BMI), the patients were divided into obesity group(BMI≥30kg/m2) (23 cases), overweight group(BMI: 25-30kg/m2) (22 cases), and normal group(BMI: 18.5-25kg/m2)(25 cases). The incision length, operation time, blood loss, blood transfusion rate, pain score, hip joint function score, imaging measurement results and postoperative complications were compared among the three groups.@*Results@#All 70 patients received the operation successfully.The incision length of the obesity group was (7.4±0.2)cm, which of the overweight group was (7.2±0.1)cm, which of the normal group was (7.1±0.8)cm, the difference among the three groups was statistically significant (F=24.671, P<0.001). The patients were followed up for 9-13 months.The acetabular anteversion angle, acetabular abduction angle, pain score, mobility of hip joint, walking ability score in the obesity group were (17.8±1.2)°, (40.9±3.4)°, (1.26±0.61)points, (95.43±7.89)°, (8.10±0.27)points, respectively, which in the overweight group were (16.7±3.3)°, (42.9±2.9)°, (1.23±0.58)points, (96.78±3.22)°, (8.20±0.92) points, respectively, which in the normal group were (15.8±2.7)°, (43.9±5.1)°, (1.24±0.78)points, (97.12±6.44)°, (8.20±0.48)points, respectively.The difference of acetabular abduction angle among the three groups was statistically significant (F=9.803, P=0.002). In the obesity group, there were two cases of incision infection, two cases of deep venous thrombosis and one case of pulmonary complication, the incidence rate of complications was 5%.In the overweight group, there was one case of superficial incision infection, and one case of deep vein thrombosis, the incidence rate of complications was 2%.In the normal group, there was one case of deep venous thrombosis, the incidence rate of complications was 1%.The difference of incidence rate of complications among the three groups was statistically significant(χ2=15.31, P<0.01).@*Conclusion@#Obesity increases the surgical risk of SuperPATH total hip replacement, and more attention should be attached to perioperative and post-operative treatment for such patients.
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Objective@#To investigate the effect of square dance on bone mineral density and osphyarthrosis and gonitis in postmenopausal women.@*Methods@#The postmenopausal women who danced on a square in the Second Hospital of Wuxi Affiliated to Nanjing Medical University from January 2014 to January 2015 were selected and divided into different groups by age.Each group of subjects received the bone mineral density test of their lumbar vertebral body 1-3, so as to analyze the difference between the bone mineral density of each vertebral body and the corresponding age, as well as the relationship between the age and the bone mineral density.The bone mineral density of their lumbar vertebrae was measured one year later, and the incidence rates of osphyarthrosis and gonitis were observed, thus the influence of square dancing on bone mineral density and the incidence of osphyarthrosis and gonitis of postmenopausal women was studied.@*Results@#There was statistically significant difference in the bone mineral density for lumbar vertebrae of different age groups(F=74.213, P<0.01), among which the bone mineral density of lumbar vertebrae 1~3 in the age group of 45-60 showed a decreasing trend, with a medium negative correlation with age(r=0.978). After dancing on a square for 1 year, the bone mineral density of lumbar vertebral body 1-3 of subjects in the age group of 45-50, the age group of >50-55, the age group of >55~60, the age group of >60-65, the age group of >65-70 and the age group of over 70 were (149.51±31.65)mg/cm3, (118.98±34.55)mg/cm3, (103.56±23.44)mg/cm3, (86.88±34.21)mg/cm3, (69.89±29.72)mg/cm3, (61.22±34.21)mg/cm3, respectively, which increased slightly; the bone mineral density of the age group of 45-50, the age group of >50-55 and the age group of >55-60 increased significantly(F=8.012, 3.567, 4.774, all P<0.05). Square dancing had no significant effect on the incidence of osphyarthrosis and gonitis of postmenopausal women.@*Conclusion@#The age group of 45-60 is the most obvious period of bone mineral density decline for women.Square dancing can effectively improve the bone mineral density of postmenopausal women in this age group, but has no obvious effect on the improvement of the bone mineral density of women in other age groups.Square dancing has no effect on the incidence of osphyarthrosis and gonitis of postmenopausal women.
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Objective To explore the effect of obesity on the treatment for femoral neck fracture in patients with SuperPATH hip replacement.Methods Seventy patients who were treated with SuperPATH hip replacement in the Second People's Hospital of Wuxi from January 2014 to January 2017 were selected in the study.Based on their body mass index(BMI),the patients were divided into obesity group(BMI ≥30kg/m2) (23 cases),overweight group (BMI:25-30kg/m2) (22 cases),and normal group(BMI:18.5-25kg/m2) (25 cases).The incision length,operation time,blood loss,blood transfusion rate,pain score,hip joint function score,imaging measurement results and postoperative complications were compared among the three groups.Results All 70 patients received the operation successfully.The incision length of the obesity group was (7.4 ± 0.2) cm,which of the overweight group was (7.2 ±0.1) cm,which of the normal group was (7.1 ± 0.8) cm,the difference among the three groups was statistically significant (F =24.671,P ＜ 0.001).The patients were followed up for 9-13 months.The acetabular anteversion angle,acetabular abduction angle,pain score,mobility of hip joint,walking ability score in the obesity group were (17.8 ± 1.2) °,(40.9 ± 3.4) °,(1.26 ± 0.61) points,(95.43 ± 7.89) °,(8.10 ± 0.27) points,respectively,which in the overweight group were (16.7 ± 3.3) °,(42.9 ± 2.9) °,(1.23 ± 0.58) points,(96.78 ± 3.22) °,(8.20 ±0.92) points,respectively,which in the normal group were (15.8 ± 2.7) °,(43.9 ± 5.1) °,(1.24 ± 0.78) points,(97.12 ± 6.44)°,(8.20 ± 0.48)points,respectively.The difference of acetabular abduction angle among the three groups was statistically significant (F =9.803,P =0.002).In the obesity group,there were two cases of incision infection,two cases of deep venous thrombosis and one case of pulmonary complication,the incidence rate of complications was 5％.In the overweight group,there was one case of superficial incision infection,and one case of deep vein thrombosis,the incidence rate of complications was 2％.In the normal group,there was one case of deep venous thrombosis,the incidence rate of complications was 1％.The difference of incidence rate of complications among the three groups was statistically significant (x2 =15.31,P ＜ 0.01).Conclusion Obesity increases the surgical risk of SuperPATH total hip replacement,and more attention should be attached to perioperative and post-operative treatment for such patients.
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Objective To discuss the incidence, clinical features, diagnostic methods, treatment and prognostic factors of Hodgkin lymphoma of breast. Methods The clinical data, diagnosis, treatment and prognosis of one male patient diagnosed as Hodgkin lymphoma of breast were retrospectively analyzed, and literatures were reviewed. Results The 71-year-old male patient had a main physical sign of a local painless lump in breast. The lump increased progressively, associated with generalized lymphadenopathy, skin itching and sweats. Pathologic results showed the diagnosis of classical Hodgkin lymphoma (Ann Arbor stage: ⅢEB). The patient eventually died after 7 months following the combined chemotherapy. Conclusions Hodgkin lymphoma of breast is a rare disease lacking in specific clinical manifestations. It is difficult to clarify the diagnosis before operation, and its definite diagnosis largely depends on pathological and immunohistochemical examination. The combination of chemotherapy with radiotherapy may have a favorable efficacy, with the poor diagnosis.
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Objective:To investigate the role of Smad7 in the Hepatocellular carcinoma (HCC) migration and proliferation and its clinical significance.Methods:Through transfecting pcDNA3.1 (+)-Smad7 or siRNA Smad7 to overexpress or knockdown the Smad7 expression in HCC cell lines HepG2 and Huh7.The MTT assays were used to test the role of Smad7 in proliferation of HCC cells.Transwell and wound-healing assays were used to detect the effect of Smad7 on migratory ability in both tow cell lines.RT-PCR was used to test the Smad7 expression in 9 clinical HCC patients' specimens.Results:As the results,overexpression of Smad7 significantly inhibited the proliferation of cells compared with the control group,while knockdown Smad7 promoted the proliferation.At the same time,overexpression of Smad7 could inhibit the migratory ability of HCC cells compared with the control group,while knockdown smad7 could accelerate this ability.The expression of Smad7 in cancer tissue was significantly lower compared with normal mucosa tissue adjacent to cancer.Conclusions:Smad7 is a kind of anti-progressive molecule in HCC.
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Objective To evaluate the distribution and significance of IgG subclasses of anti-cyclic cirullinated peptide antibody (anti-CCP) in sera from patients with rheumatoid arthritis (RA).Methods A total of 83 patients with RA at the Department of Endocrinology of Taizhou Hospital , 51 disease controls and 50 healthy controls during the period from August 2012 to June 2013 were enrolled.The total serum IgG and IgG subclasses of anti-CCP antibodies were detected by antigen specific enzyme linked immune-sorbent assay( ELISA ).The prevalence and relative amount of IgG subclasses were calculated and compared.Statistical analysis was performed by χ2 test and Kruskal-Wallis H test.Results The positive rates of IgG subclasses of anti-CCP were anti-IgG 71.1%(59/83), anti-IgG1 78.3%(65/83), anti-IgG2 26.5%(22/83), anti-IgG3 60.2%(50/83), anti-IgG4 74.7%(62/83) respectively.The diagnostic value of anti-CCP-IgG1, anti-CCP-IgG3 and anti-CCP-IgG4 alone or combined (AUC =0.818-0.901),compared with anti-CCP-IgG(AUC=0.857), had no significant difference(Z=0.028-0.045,P>0.05).The DAS28 score of anti-CCP-IgG1(DAS28 =6.5), and anti-CCP-IgG4(DAS28 =6.5)positive in patients with RA were significantly higher than those in negative groups (DAS28=4.5,4.6)(U=396.0,427.5,P<0.01).The T28(T28=4.0,4.0)and SW28(SW28=4.0,4.0) results of CCP-IgG1and CCP-IgG4 positive in patients with RA were significantly higher than those in negative groups (T28=3.0,3.0,SW28 =3.0,3.0)(U=377.5,406.0,255.5,286.5,P<0.05).Conclusions The distribution of IgG subclasses of anti-CCP in sera from patients with RA was predominantly anti-CCP-IgG1, anti-CCP-IgG3 and anti-CCP-IgG4 associated with RA disease activity.However , whether joint detection of IgG subclasses can replace conventional anti -CCP is questionable.
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Objective To investigate the clinical characteristics and the course of diagnosis and therapy of asparaginase associated pancreatitis (AAP) in adults, in order to improve the ability of diagnosis and treatment.Methods Data of 384 cases of acute lymphoblastic leukemia (ALL) who received treatment in Department of Hematology, Zhejiang Hospital, and Department of Hematology, Second Hospital Affiliated to Wenzhou Medical University from January 2009 to June 2015 was retrospectively analyzed.All patients were given multi-drug chemotherapy including PEG-asparaginase or L-asparaginase, the incidence of AAP, clinical manifestations, diagnosis, treatment and prognosis were analyzed.Results Among the 384 cases, 18 patients developed AAP, and the incidence of AAP was 4.7％, including 13 cases of mild AAP (MAAP), 5 cases of severe AAP (SAAP).Sixteen cases of AAP occurred during the induction-remission treatment phase, 2 cases during the maintenance-intensification phase.The major manifestations of AAP were abdominal pain, and increased serum amylase and lipase.After treatment, abdominal pain of MAAP patients alleviated, serum amylase and lipase obviously decreased, and re-use of PEG-Asparaginase or L-Asparaginase was not associated with the recurrence of AP.Levels of serum amylase and lipase in 5 cases of SAAP repeatedly increased, 1 case died of severe infection, cyst rupture and hemorrhage.Conclusions Adults patients with ALL present with abdominal pain during chemotherapy of aspargase should consider the possibility of AAP, the measurement of serum amylase and serum lipase should be strengthened, in addition, ultrasound and CT scanning may be helpful for early diagnosis and treatment of AAP, and improve the prognosis.
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Objective To investigate the frequency and mutational status of JAK2V617F mutation in Chinese patients with chronic myeloproliferative disorders(CMPD) and to study the relative quantification of mutated JAK2 mRNA and the clinical significance. Methods JAK2V617F mutation and the mutational status were screened with amplification-refractory mutation system polymerase chain reaction(ARMS-PCR), the relative quantification of mutated JAK2 mRNA was studied by using capillary electrophoresis. Results A higher prevalence of JAK2V617F in either the heterozygotc or homozyote status in essential thrombocythemia (ET) was observed in elderly patients with ET (P<0.05). The presence of JAK2V617F was found to be significantly correlated with the age at diagnosis (P<0.05); patients with age ≥ 60 years showed significantly higher JAK2 mutated RNA levels than those with age < 60 years (P<0.05); the presence of JAK2V617F in polycythemia vera (PV) and ET was found to be significantly associated with higher hemoglobin level and higher leukocyte count (P< 0.05). In addition, higher leukocyte count was observed in homozygous ET patients than in heterozygous ET patients (P<0.05). The frequency of JAK2V617F mutation and the prevalence of homozygote in PV patients were higher than those in ET patients (P<0.05). The differences of JAK2V617F mRNA levels among PV, ET and chronic idiopathic myelofibrosis (IMF) were not significant. Conclusions ARMS-PCR technique can be used to detect the frequency and mutational status of JAK2V617F mutation owing to its sensitivity and along with capillary electrophoresis, quantitative assay for mutated JAK2 mRNA, diagnosis of CMPD and judgement of prognosis become possible.
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<p><b>OBJECTIVE</b>To study the clinical, biological features and prognosis of acute biphenotypic leukemia (BAL) in the adults.</p><p><b>METHODS</b>Bone marrow specimens of 63 BAL patients were evaluated to prove the diagnosis and the classification by morphologic, cytochemical, immunologic and cytogenetic (MIC) examinations. These patients were treated with protocols suitable for acute myeloid leukemia (AML), or acute lymphoblastic leukemia (ALL), or both.</p><p><b>RESULTS</b>No significant difference in clinical features was observed between BAL, AML or ALL. Morphologically, the subtypes of M(5), M(1) and M(2) were predominant in AML, as L(2) and L(1) were in ALL. Immunologically, coexpression of myeloid and B lineage associated antigens was predominant and CD(34) was hyperexpressed in BAL, which suggested that BAL might originate from malignant transformation of earlier hematopoietic cells. Cytogenetically, Ph chromosome was observed in 25.5% (13/51) of BAL patients. Prognostically, both the treatment response and the overall survival of BAL patients were poor.</p><p><b>CONCLUSION</b>Patients with BAL have unique clinical, biological and prognostic features.</p>