Effect of Hematocrit Injury on the Survival Rate of Advanced Malignant Tumors and Its Clinical Significance.

Objective: To investigate the effect of logistic multivariate analysis on the survival rate of advanced malignant tumors and to evaluate the effect of erythrocyte storage injury on the survival rate of advanced malignant tumors and its clinical significance. Methods: A retrospective analysis was performed on 120 advanced cancer patients who received blood transfusion in Shaanxi Cancer Hospital from March 2018 to June 2019, and the risk factors for death were analyzed. A total of 72 advanced cancer patients admitted to hospital from March 2019 to June 2021 were included in the study. The patients with red blood cell transfusion storage time ≤ 14 d were the study group (n = 36), and the patients with red blood cell transfusion storage time > 14 d were the control group (n = 36). Compare the total efficiency of blood transfusion. The levels of Hb, erythrocyte count, hematocrit (HCT), blood oxygen saturation (SPO2), creatinine (Cr), erythrocyte deformability index, whole blood, erythrocyte, and hemoglobin before and after blood transfusion were compared, and the adverse reactions of blood transfusion were recorded. Results: Dyspnea and delirium were significantly associated with patient survival time (P < 0.05). Red blood cell storage time ≤ 14 days, Lym% < 12%, lactate dehydrogenase (LDH) > 500 U/L, and ALB < 30 g/L were significantly correlated with survival time. Karnofsky performance status (KPS) < 30, delirium, LDH > 500 U/L, and albumin (ALB) < 30 g/L were independent influencing factors of survival (P < 0.05). The overall effective rate of the research group was higher (P < 0.05). The incidence of adverse reactions in the study group was lower (P < 0.05). The levels of Hb, red blood cell count, and HCT in the study group were higher (P < 0.05). Compared with the control group, the SPO2 level and the red blood cell deformability index were higher in the study group (P < 0.05). After blood transfusion, the level of (diphosphoglycerate) DPG in the study group was higher than that in the control group (P < 0.05). The length of hospital stay in the study group was significantly shortened (P < 0.05). The nosocomial infection rate and case fatality rate in the study group were significantly reduced (P < 0.05). Conclusion: Red blood cell storage time ≤ 14 d, LYM% < 12%, LDH > 500 U/L, and ALB < 30 g/L are all significantly correlated with survival time. KPS < 30, delirium, LDH > 500 U/L, and ALB < 30 g/L were independent factors for survival (P < 0.05). Transfusion of red blood cells stored for ≤14 days in patients with advanced malignant tumors can significantly increase the effective infusion rate, improve anemia status, shorten hospital stay, and reduce mortality and risk of nosocomial infection and is worthy of clinical promotion.

Genetic Variants of the MIF Gene and Susceptibility of Rectal Cancer.

BACKGROUND: Rectal cancer (RC) has been documented to be a highly invasive malignant neoplasm worldwide. Macrophage migration inhibitory factor (MIF) is a multifunctional cytokine involved in cell-mediated immunity, immunoregulation, inflammation. In vitro and in vivo studies have identified that MIF was involved in the carcinogenesis and progression of RC. PATIENTS AND METHODS: This case-control study evaluated associations of genetic variants of the MIF gene and serum level of MIF with susceptibility of RC. RESULTS: We found MIF level was associated with an increased risk of RC (OR for per unit: 1.38, 95% CI:1.32-1.44; P < 0.001). Both MIF rs2012133 (OR = 1.30; 95% CIs = 1.08-1.58; P = 0.007) and rs755622 (OR = 1.45; 95% CIs = 1.15-1.82; P = 0.002) were significantly associated with increased risk of RC. Besides, we also found MIF rs5844572 was significantly associated with increased susceptibility of RC, with OR for per CATT repeat of 1.28 (95% CIs: 1.16-1.41; P < 0.001). Further, we found all three variants of the MIF gene, rs5844572, rs2012133 and rs755622, could increase serum level of MIF. CONCLUSION: This study suggests that MIF plays an important role in the carcinogenesis of RC and could be used as a biomarker for early detection and prediction of RC.

LncRNA MIR503HG is downregulated in Han Chinese with colorectal cancer and inhibits cell migration and invasion mediated by TGF-ß2.

In this study we investigated the role of lncRNA MIR503HG in colorectal cancer (CRC). We found that MIR503HG was downregulated and TGF-ß2 was upregulated in CRC included in this study. Low levels of MIR503HG were associated with poor survival of CRC patients within 5 years after admission. MIR503HG and TGF-ß2 were inversely correlated in CRC tissues, and in CRC cells, MIR503HG overexpression was accompanied by TGF-ß2 downregulation, while TGF-ß2 overexpression did not affect MIR503HG. TGF-ß2 overexpression mediated the increased migration and invasion rates of CRC cells. MIR503HG overexpression mediated the decreased migration and invasion rates of CRC cells. Moreover, TGF-ß2 overexpression reduced the effects of MIR503HG overexpression. Therefore, MIR503HG overexpression inhibits CRC cell migration and invasion mediated by TGF-ß2.

Role of serine/threonine kinase 33 methylation in colorectal cancer and its clinical significance.

Serine/threonine kinase 33 (STK33) is a novel protein that has been the focus of an increasing number of studies in recent years; however, the role of STK33 in tumorigenesis remains controversial. Previous studies have demonstrated that STK33 is overexpressed in several human cancers and exerts a pro-tumorigenic effect through the promotion of cell proliferation. However, the role of STK33 in colorectal cancer (CRC), which is one of the most aggressive human malignancies, remains unclear. The aim of the current study was to investigate the methylation status of STK33 in CRC and to determine its clinical significance. The results demonstrated that STK33 was hypermethylated in CRC cell lines and promoted the proliferation of CRC cells. In addition, the methylation status and expression of STK33 in 94 pairs of cancer and noncancerous tissues obtained from patients with CRC was investigated. STK33 methylation was significantly increased in cancer tissues when compared with adjacent noncancerous tissues (P<0.001). STK33 methylation was associated with lymph node metastasis (P<0.05), tumor invasion (P<0.05), distant metastases (P<0.01) and tumor stage (P<0.01). Reduced STK33 mRNA and protein expression in CRC was associated with STK33 hypermethylation (P<0.001). In addition, patients with hypermethylated STK33 exhibited shorter overall survival rates when compared with those with unmethylated STK33 (P<0.01). In conclusion, the results of the current study suggest that STK33 hypermethylation may be a promising novel biomarker for the diagnosis, prognosis and suitable treatment of CRC.

Overexpression of miRNA-143 Inhibits Colon Cancer Cell Proliferation by Inhibiting Glucose Uptake.

MiRNA-143 overexpression is related to upregulated blood glucose level in diabetic mice, and downregulated miRNA-143 has been observed in several types of cancers, indicating its role as a tumor suppression miRNA. Glucose metabolism plays pivotal roles in tumor growth. Therefore, miRNA-143 may target glucose metabolism to inhibit tumor growth. Up to now, the functionality of miRNA-143 in colon cancer is still largely unknown. Our study was carried out to investigate the role of miRNA-143 in colon cancer and to explore the interactions between miRNA-143 and glucose uptake pathway. In this study we observed that miRNA-143 was downregulated in both colon biopsies (tumor tissues for colon cancer patients) and whole blood of colon patients than in healthy controls. Downregulation of miRNA-143 effectively distinguished colon cancer patients from healthy controls. Expression levels of miRNA-143 were found to be significantly correlated with tumor size but not distant tumor metastasis. MiRNA-143 overexpression inhibited glucose uptake and glucose transporter 1 (GLUT1) expression in colon cancer cells. MiRNA-143 overexpression also inhibited colon cancer cell proliferation. We therefore concluded that overexpression of miRNA-143 inhibited colon cancer cell proliferation by inhibiting glucose uptake.

Endovascular repair of a tuberculous aneurysm of descending thoracic aorta.

Tuberculous aortic aneurysm (TBAA) is an extremely rare clinical event with life-threatening implication. Management for this condition is challenging and its therapeutic option has not been yet established. A few recent reports described endovascular repair rather than open surgery as the method for treatment. Although this remains controversial, endovascular exclusion has been gaining acceptance for some surgeons. We present a case of TBAA who was treated by endovascular stent grafting for a descending thoracic aortic aneurysm with simultaneous anti-tuberculous medication. The outcome was favorable.

Inflammatory abdominal aortic aneurysm: clinical features and long term outcome in comparison with atherosclerotic abdominal aortic aneurysm.

BACKGROUND: Inflammatory abdominal aortic aneurysms (IAAAs) are rare but distinct clinical entities of atherosclerotic abdominal aortic aneurysms (aAAAs). In this study we report a 20-year single institution experience for IAAA and analyze their clinical features and long term outcome in comparison with aAAA. METHODS: Between 1988 and 2008, 412 cases of abdominal aortic aneurysms (AAAs) underwent elective surgical operations, 11 (2.7%) of whom were diagnosed as IAAAs and 389 (94.4%) were diagnosed as aAAAs. The former group was matched in a case control fashion to a group of 33 patients with aAAAs having similar characteristics of age, gender, and preoperative risk factors. All available clinical, pathologic, and postoperative variables were retrospectively reviewed, and the two groups were compared. RESULTS: The two groups did not differ significantly in clinical characteristics and preoperative risk factors, although patients with IAAAs were significantly more symptomatic (100% vs. 42.4%, P = 0.001) and had larger aneurysms on admission ((7.4 +/- 0.7) cm vs. (6.3 +/- 0.9) cm, P = 0.006). In IAAAs, the preoperative erythrocyte sedimentation rate was found to be significantly elevated compared to aAAA group ((44.5 +/- 9.1) mm/h vs. (11.4 +/- 5.4) mm/h, P < 0.05). Surgical morbidity and mortality rates did not differ between the two groups. The operation time for patients with IAAAs was significantly longer than that for patients with aAAAs ((308 +/- 36) minutes vs. (224 +/- 46) minutes, P < 0.05), but the cross-clamp time was similar in both groups ((41.5 +/- 6.2) minutes vs. (41.8 +/- 6.2) minutes, P = 0.92). A five-year survival rate analysis showed no significant difference between the two groups (P = 0.711). CONCLUSIONS: Despite having more symptoms, larger size and longer operation time, patients with IAAA can now be treated with approaches that cause low morbidity and mortality, similar to patients with aAAA. Long term outcome of IAAA patients is of no difference from aAAA patients.

Deficient CD4+CD25+ T regulatory cell function in patients with abdominal aortic aneurysms.

OBJECTIVE: Increasing evidence shows that autoimmune response contributes importantly to pathogenesis of abdominal aortic aneurysm (AAA). This work was aimed to assess the possibly altered function of peripheral CD4(+)CD25(+) T regulatory cells (Tregs) that might breakdown immunologic self-tolerance in AAA patients. METHODS AND RESULTS: Peripheral blood from 22 AAA patients, 11 patients with abdominal aortic atherosclerotic occlusive disease (AOD), and 32 healthy controls (HCs) was analyzed to determine the percentage of CD4(+)CD25(+) Tregs in the total CD4(+) T-cell population and FOXP3 expression by means of flow cytometry. The frequencies of the CD4(+)CD25(+) Treg population were not significantly different between groups (AAA, 5.69+/-0.99%; AOD, 5.52+/-1.13%; HC, 5.88+/-1.55%; P>0.05). However, the frequency of CD4(+)CD25(+)FOXP3(+) T cells in AAA patients (2.45+/-0.57%) was significantly lower than that in AOD group (3.41+/-0.72%; P<0.01) or in HCs (3.69+/-0.82%; P<0.01). A comparison of FOXP3 mRNA and protein expression revealed significantly lower levels in CD4(+)CD25(+) Tregs from AAA group than either of other 2 groups (P<0.01). Suppressive function assay showed that freshly isolated CD4(+)CD25(+) Tregs from patients with AAA exhibited significantly less suppressive activity than those from AOD patients or HCs (P<0.01). Mixing cultures with CD4(+)CD25(+) T cells and CD4(+)CD25(-) T cells from AAA patients and HCs demonstrated that the primary regulatory defect is due to a dysfunction of CD4(+)CD25(+) Tregs, and not a resistance of CD4(+)CD25(-) responder T cells to suppression in AAA patients. CONCLUSIONS: Our data demonstrate a reduced level of FOXP3 expression in peripheral CD4(+)CD25(+) Tregs and decreased frequency of CD4(+)CD25(+)FOXP3(+) T cells in a cohort of AAA patients enrolled in the study, which leads to a functional deficiency of CD4(+)CD25(+) Tregs as a whole. This indicates an impaired immunoregulation by Tregs that may contribute to AAA pathogenesis.

[The comparison of operative and non-operative treatment for acute embolism of upper extremity artery].

OBJECTIVE: To compare surgical and non-surgical therapy of the upper extremity after acute arterial occlusion. To analyze the relation between prognosis and relevant factors of different therapeutic methods. METHODS: Sixty patients with acute upper extremity arterial embolism treated between January 1990 and October 2007 were retrospectively studied in The First Hospital of China Medical University. RESULTS: There were 60 patients, 32 men and 28 women, with a mean age of 63 years (21 - 86 years). Among them, 31 underwent thrombembolectomies with the Fogarty catheter and 29 received anti-coagulation and thrombolytic therapy. Therapeutic effects were evaluated by Cooley's standard. Therapeutic efficacy was better in the surgical group than in the non-surgical group (P < 0.05). There was no relationship between post-operative ischemic recovery and pre-operative ischemia severity and the site of embolism in the surgical group, while there were significant relationships in the nonsurgical group. The result of Cox proportional hazard regression model showed that the age and Cooley's standard of the patient was correlated with survival time. CONCLUSIONS: A more active surgical approach is better for the treatment of acute arterial occlusion of the upper extremity.

[Clinico-epidemiological features of infrarenal abdominal aortic aneurysm and relevant prognostic factors].

OBJECTIVE: To investigate the clinico-epidemiology features of infrarenal abdominal aortic aneurysm (AAA) and relevant prognostic factors. METHODS: The clinical records of 375 infrarenal AAA patients, 282 males and 93 females, aged (62 +/- 15), hospitalized 1988 -2007 were analyzed. RESULTS: In recent ten years, the number of patients admitted because of AAA was 186.6% as high as that in the last 10 years. The rupture rate of the male AAA patients was 14.4%, significantly higher than that of the female AAA patients (6.5%, P < 0.05). The rupture rate of the AAA aged patients > or = 65 was 3.6%, significantly lower than that of the AAA patients < 65 (17.7%, P < 0.01). The aneurysm diameter of the patients with hyperextension was (6.1 +/- 3.3) cm, significantly lower than that of the patients without hypertension [(6.8 +/- 2.3) cm. P < 0.05]. The general 5-year survival rate was 70.1%. The 5-year survival rates of the female patients, patients > or = 65, without hypertension, and without coronary heart disease were, all significantly higher than those of the male patients, patients < 65, and patients with hypertension or coronary heart disease (all P < 0.05). Cox regression analysis showed that sex, smoking, and hypertension were all prognostic factors (all P < 0.05). CONCLUSION: The morbidity of AAA increases fiercely. The AAA patients being male, smoking, or with hypertension have poorer prognosis, and age and operation method are not related to prognoses.