Evaluation of Therapeutic Response to Endocrine Therapy for Prostate Cancer by MRI Diffusion-weighted Imaging Based on PI-RADSv2.1 / 肿瘤防治研究

Objective To investigate the value of MRI diffusion-weighted imaging (DWI) technique in endocrine therapy for prostate cancer (PCa) based on PI-RADSv2.1. Methods A retrospective analysis of 57 patients with pathologically confirmed PCa was conducted. All patients underwent multi-parametric MRI (mpMRI) according to PI-RADS v2.1 technical specifications before biopsy and six months after endocrine therapy. The apparent diffusion coefficient (ADC) values were measured in cancer and non-cancer areas before biopsy and six months after endocrine therapy. Patients were grouped based on the mRECIST criteria and PSA level into responders (n=45) and non-responders (n=12). ROC curves were obtained to assess the correlation between changes in ADC values and PSA values before and after endocrine therapy. Results In the responder group, the ADC value of the cancer areas was increased significantly after endocrine therapy (P<0.001). No statistically significant difference of the ADC value of the cancer areas was found in the non-responder group before and six months after endocrine therapy (P=0.714). The ADC change of responders and non-responder groups were (0.411±0.178)×10-3 mm2/s and (-0.014±0.125)×10-3 mm2/s, respectively (P<0.001); the ADC ratio were (60.603±30.201)% and (-1.096±13.175)%, respectively (P<0.001). The cutoff value of the ADC change was 0.165 (AUC=0.974; sensitivity, 88.89%; specificity, 100.00%; PPV, 100.00%; NPV, 70.59%). The cutoff value of ADC ratio was 16.827% (AUC=0.980; sensitivity, 91.11%; specificity, 100.00%; PPV, 100.00%; NPV, 75.00%). The ADC values were negatively correlated with serum PSA before and after endocrine therapy. Conclusion The ADC change and ADC ratio may be facilitated to monitor the efficacy of endocrine therapy for PCa. The ADC values were negatively correlated with serum PSA.

miR-155-5p Promotes Invasion and Migration of MCF-7 Breast Cancer Cell by Down-regulating SOX1 / 华中科技大学学报(医学版)

Objective To examine the mechanism by which miR-155-5p regulates sex determining region Y-boc 1(SOX1) expression in breast cancer cell line MCF-7,and to investigate the effect of miR-155-5p on the invasion and metastasis of these cells.Methods After up-regulation or down-regulation of the expression of miR-155-5p in MCF-7 cells,the transwell assay was performed to detect the invasive and migrating ability of MCF-7 cells;SOX1 mRNA expression and protein levels were detected by real-time PCR and Western blot,respectively;immunofluorescence was used to test the distribution and levels of SOX1 pro-tein,and dual luciferase reporter experiments to discover the binding of miR-155-5p to the 3′-UTR region of SOX1 mR-NA.Results Up-regulating the expression of miR-155-5p could enhance the migrating and invasive ability of MCF-7 cells and simultaneously decrease the mRNA and protein levels of SOX1(P <0.05).On the contrary,inhibition of miR-155-5p depressed the invasion and migration of MCF-7 cells and increased the expression of SOX1(P < 0.05).Dual luciferase reporter experi-ments confirmed that miR-155-5p could bind to the specific sequence in the 3′-UTR of SOX1 mRNA and play a role of regula-tor.Conclusion miR-155-5p promotes the invasion and migration of breast cancer cell line MCF-7 via inhibiting the expression of SOX1.

Investigation and analysis of medical students' autonomous learning / 中华医学教育探索杂志

Objective Through a survey of medical students in autonomous learning, to understand students' learning motivation and learning strategies and find out the existing problems, and to provide the basis for the school to organize autonomous learning and improve the teaching quality. Methods Convenient sampling method was used to extract 1 500 students' autonomous learning scale who were freshman and sophomore, junior students and 1 467 valid questionnaires were collected. According to the corresponding research situation of Zhejiang Normal University, SPSS 19.0 was used to compare the different types of students in the school, and the t test or q test were also done. Results The situation of college students' autonomous learning was better. The girl's average score was (312.51 ±14.03) which was higher than the boys in the school (286.16 ±13.69)and the girls in the control group (302.67 ±10.37). The difference was statistically significant (P<0.05). The average total score of the junior college students (307.92 ±13.84) was better than that of freshman and sophomore (P<0.05), which suggested that junior students had the strongest independent learning ability. Conclusion Colleges and universities should be based on the actual situation of students and formulate corresponding policies and measures from the autonomous learning motivation, the boys dor-mitory management, to ensure the stability of teaching quality improvement.

Predictors of in-stent restenosis in coronary heart disease patients complicating with diabetes mellitus within 2 years after drug-eluting stents implantation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To determine predictors for in-stent restenosis (ISR) within 2 years after drug-eluting stent (DES) implantation in coronary heart disease patients complicating with diabetes mellitus and to establish predictive model.</p><p><b>METHODS</b>We retrospectively analyzed clinical data of patients underwent DES implantation in our hospital between January 2005 and December 2012. Using random number generated by SPSS 17.0, a total of 3 073 cases were randomly divided into two cohort, model derivation cohort (MDC) and model validation cohort (MVC). MDC (2 048 cases) was divided into in-stent restenosis (ISR) group and control group. Predictors were identified using univariable and multivariable logistic regression analysis in MDC. Integer point values were assigned to each predictor based upon their β coefficient in multivariable logistic regression model to establish scoring model. The summed scores of each case in MVC (1 025 cases) were calculated to test predictive ability of the model.</p><p><b>RESULTS</b>Of all these 3 073 cases, 217 cases (7.1%) were diagnosed with ISR within 2 year after DES implantation. The incidence of ISR within 2 year after DES implantation was 7.3% (149 cases) in MDC and logistic regression analysis identified six ISR risk factors: multiple target vessels (OR = 3.69, 95%CI: 2.65-8.93, P = 0.000), diffused lesions (OR = 2.92, 95%CI: 2.03-6.46, P = 0.000), GFR < 60 ml×min(-1)·1.73 m(-2) (OR = 4.73, 95%CI: 3.51-10.62, P = 0.000), smoking (OR = 3.37, 95%CI: 2.39-8.46, P = 0.000), age < 60 years old (OR = 1.44, 95%CI:1.26-4.63, P = 0.024), HbAlc ≥ 6.3% (OR = 2.48, 95%CI: 1.84-4.27, P = 0.002). Risk score was well associated with the rate of ISR in MVC. Sensitivity was 76.5% (95%CI: 64.6%-85.9%), specificity was 76.1% (95%CI: 73.2%-78.7%), and areas under the ROC curve was 0.851(95%CI:0.813-0.890, P = 0.000) when score was set at 5.5.</p><p><b>CONCLUSIONS</b>The incidence of ISR in coronary heart disease patients complicating with diabetes mellitus within 2 years after DES implantation is relatively low. Several factors are associated with ISR in these patients and risk for ISR could be reliably identified by the established scoring model.</p>

Systematic reviews in the telomerase activity testing for screening lung cancer by use of SROC curve method / 实用肿瘤学杂志

Objective To evaluate the clinical significance of telomerase in the diagnosis of lung cancerusing SROC curve method.Methods Looking“telomerase”and“lung cancer”as keywords,retrieving journalspublished within past 20 years in order to incorporate into literatures and to collect data .To conduct the SROC analysisusing Meta -DiSc 1.4 software.Results 1.Twenty -two documents were sampled as tissue specimensand the heterogeneity was relatively large (P =0.017).To analyze the data with random effective models ,thecombined sensitivity and specificity were 0.788(0.761 -0.814)and 0.955(0.936 -0.969),respectively.TheSROC AUC area under the curve was 0.9515,SE(AUC) =0.0145.2.There was no heterogeneity(P =0.633)amongthe 10 lavaged literatures.By use of fixed effects model for data analysis ,the combined sensitivity and specificitywere 0.777(0.734 -0.816) and 0.922(0.888 -0.948),and SROC AUC area under the curve was0.9369,SE(AUC) =0.0141.Conclusion Telomerase is a ideal tumor marker,and the detection of telomeraseactivity in lavage fluid is stable and accurate in clinical diagnosis .

Epidemiological characteristics of thyroid nodules and risk factors for malignant nodules: a retrospective study from 6,304 surgical cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The prevalence of thyroid nodules (TN) is increasing rapidly. This study analyzed the epidemiological and clinical characteristics of TN in surgically treated patients and identified the risk factors for malignant nodules (MN) to provide more understanding of the differential diagnosis of TN.</p><p><b>METHODS</b>A total of 6 304 TN cases who underwent thyroid surgery were included in this retrospective study. The clinical data were collected to evaluate the clinical and epidemiological characteristics and related risk factors for MN. The nature of TN (benign nodules (BN) or MN), medical records, laboratory data, and imaging data were analyzed. The risk factors for MN were screened using Spearman's rank correlation analysis and nonconditional binary Logistic regression analysis.</p><p><b>RESULTS</b>The number of surgically treated TN cases increased yearly. A total of 34.33% of cases were MN and 65.67% were BN. Up to 56.74% of these cases underwent unnecessary surgery. Among the MN cases, papillary thyroid carcinoma accounted for 94%, in which 46.71% coexisted with benign thyroid disease and 32.28% with multiple foci. Single-related factor analysis showed that age, employment, disease duration, history of breast nodules and/or hypertension, the levels of serum thyroid-stimulating hormone (TSH), thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPoAb), and ultrasound features of TN were related to MN. Stepwise nonconditional binary Logistic regression analysis showed that 13 factors may be the independent risk factors for MN, including <40 years old, previous history of breast nodules and/or hypertension, disease duration <1 month, employment, hypoechoic nodule, irregular nodules, nodule calcification, solid echo nodule, fuzzy boundary, rich blood flow within nodules, abnormal lymph nodes around the neck, nodule diameter <1 cm, and abnormally high TgAb.</p><p><b>CONCLUSIONS</b>Our results demonstrate a rapid increase in surgically treated TN cases and ratio of MN and indicate unnecessary surgeries in some cases. This study also suggest that age, duration of thyroid disease, history of breast disease and/or hypertension, the levels of serum TSH, TgAb, and TPoAb, and ultrasound features of TN are related to MN, and some of these factors may be the risk factors for MN.</p>