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BACKGROUND@#The SMARCA4 mutation has been shown to account for at least 10% of non-small cell lung cancer (NSCLC). In the present, conventional radiotherapy and targeted therapy are difficult to improve outcomes due to the highly aggressive and refractory nature of SMARCA4-deficient NSCLC (SMARCA4-DNSCLC) and the absence of sensitive site mutations for targeted drug therapy, and chemotherapy combined with or without immunotherapy is the main treatment. Effective SMARCA4-DNSCLC therapeutic options, however, are still debatable. Our study aimed to investigate the efficacy and prognosis of programmed cell death 1 (PD-1) immune checkpoint inhibitors (ICIs) in combination with chemotherapy and chemotherapy in patients with stage III-IV SMARCA4-DNSCLC.@*METHODS@#46 patients with stage III-IV SMARCA4-DNSCLC were divided into two groups based on their treatment regimen: the chemotherapy group and the PD-1 ICIs plus chemotherapy group, and their clinical data were retrospectively analyzed. Efficacy assessment and survival analysis were performed in both groups, and the influencing factors for prognosis were explored for patients with SMARCA4-DNSCLC.@*RESULTS@#Male smokers are more likely to develop SMARCA4-DNSCLC. There was no significant difference in the objective response rate (76.5% vs 69.0%, P=0.836) between chemotherapy and the PD-1 ICIs plus chemotherapy or the disease control rate (100.0% vs 89.7%, P=0.286). The one-year overall survival rate in the group with PD-1 ICIs plus chemotherapy was 62.7%, and that of the chemotherapy group was 46.0%. The difference in median progression-free survival (PFS) between the PD-1 ICIs plus chemotherapy group and the chemotherapy group was statistically significant (9.3 mon vs 6.1 mon, P=0.048). The results of Cox regression analysis showed that treatment regimen and smoking history were independent influencing factors of PFS in patients with stage III-IV SMARCA4-DNSCLC, and family history was an individual influencing factor of overall survival in patients with stage III-IV SMARCA4-DNSCLC.@*CONCLUSIONS@#Treatment regimen may be a prognostic factor for patients with SMARCA4-DNSCLC, and patients with PD-1 ICIs plus chemotherapy may have a better prognosis.
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Humanos , Masculino , Carcinoma de Pulmón de Células no Pequeñas/genética , Neoplasias Pulmonares/genética , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Receptor de Muerte Celular Programada 1/genética , Estudios Retrospectivos , Antineoplásicos Inmunológicos/uso terapéutico , Pronóstico , ADN Helicasas/genética , Proteínas Nucleares/genética , Factores de Transcripción/genéticaRESUMEN
Objective To explore the value of degree of cranial suture closure in forensic adult age estimation by thin-layer CT scan and establish an adult age estimation model of the Han nationality. Methods Thin-layer CT scan samples of the heads of 220 healthy Sichuan Han adults (110 males, 110 females) aged 20 to 70 were collected, of which 20 samples (10 males, 10 females) were randomly selected as test samples. The sagittal suture, coronal suture (both left and right) and lambdoid suture (both left and right) were respectively and equally divided into 2 segments, and every segment was equally divided into 10 layers and the corresponding multiplanar reformation (MPR) images were selected. The closure of cranial sutures on MPR images was classified into the grades 1-7. The correlations between cranial sutures and age were analyzed to build regression equation for age estimation. Results The degree of closure of sagittal suture, coronal suture (both left and right) and lambdoid suture (both left and right) was positively correlated with age. The coefficient of determination (R2) of regression equation was 0.419 in males, 0.589 in females, and 0.522 in all samples. The results of the verification test showed that the mean absolute error (MAE) was 6.39 years in males, 6.16 years in females, and 6.29 years in all samples. Conclusion There was a higher accuracy in adult age estimation by thin-layer CT scan of cranial sutures. The age of Han nationality adults can be estimated by the degree of cranial sutures closure.
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Femenino , Masculino , Suturas Craneales/diagnóstico por imagen , Cabeza , Tomografía Computarizada por Rayos XRESUMEN
Objective Influenza A (FluA) poses a serious threat to human health due to its high infectivity, viral variation and rapid progression. This study aimed to analyze the characteristics of T-lymphocyte subsets in patients with severe FluA and their role in the prognosis of the disease. Methods We collected the clinical data on 80 cases of severe FluA treated in our Department of Respiratory and Critical Diseases from January 2018 to May 2019, which were divided into a death group (n = 25) and a survival group (n = 55) based on 28-day survival after admission. Thirty-one of the patients were co-infected with other pathogens at admission, of whom 11 died and 20 survived within 28 days after admission. We compared the clinical characteristics, general laboratory results and T-lymphocyte subsets (CD3+T, CD4+T and CD8+T cells) between different groups and analyzed the factors influencing the prognosis of the disease using logistic regression and multivariate COX regression analyses. Results Compared with the patients in the survival group, those in the death group showed significantly decreased counts of lymphoid, CD3+T, CD4+T and CD8+T cells, albumins and globulins (P < 0.05), but increased levels of procalcitonin, blood urea nitrogen, serum creatinine and serum glutamic-oxaloacetic transaminase (P < 0.05). CD3+T, CD4+T and CD8+T cells and albumins were remarkably decreased in the co-infection death group in comparison with the co-infection survival group (P < 0.05). The area under the ROC curve for the count of CD4+T cells was 0.728 (95% CI: 0.605-0.850), with the best cut-off value of 1.70 × 108/L, a sensitivity of 80% and a specificity of 64%. The 28-day survival rate was significantly higher in the patients with CD4+T cells ≥ 1.70×108/L than in those with CD4+T cells < 1.70×108/L (83% vs 41%, P < 0.05). COX regression analysis showed age, respiratory failure and alanine transaminase to be the risk factors while the count of CD4+T cells (RR = 0.740, 95% CI: 0.572-0.958) to be a preventive factor for the death of the patients within 28 days after admission (P < 0.05). Conclusion The count of T-lymphocytes are closely correlated to the prognosis of severe FluA and the patients with a decreased count of CD4+T cells have a higher risk of death within 28 days after admission. The count of CD4+T cells can predict the 28-day prognosis of severe FluA.
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Objective To establish regression m odel betw een craniofacial lines and body height by m ea-suring craniofacial lines in Southw est H an m ales using C Tand to accum ulate data for the study of foren-sic anthropology. Methods H ead C Tdata of 273 H an m ales in Southw est w ere collected and 7 cranio-facial lines w ere determ ined. M ultiplanar reconstruction and volum e rendering w ere perform ed by im age post-processing softw are and the selected lines w ere m easured. The relationship betw een each m easuring indicator and body height w as analyzed using SPSS 21.0 softw are. The regression equation of body height estim ation w as established and 50 sam ples w ere selected again and put into the m athem atics m odels to verify its accuracy. Results The linear regression equations of 7 lines w ere established (P<0.05). The correlation coefficients of the unary linear regression equations w ere 0.190-0.439 and the standard errors of the estim ate (SEE) w ere 4.597-5.023 cm . The correlation coefficients of the m ultiple linear regression equation w ere 0.494-0.524 and the SEEw ere 4.418-4.458 cm . The return tests show ed that the highest ±1SEEaccuracy of the m ultiple regression equation:y=83.959+3.589 x6+2.573 x2, w ere 30%;and the highest ±2SEEaccuracy of the m ultiple regression equation: y=72.646+3.316 x6+1.586 x2+1.553 x4+2.211 x3, w ere 92% . Conclusion There is significant linear correlation betw een 7 selected lines and the stature in this study, and the plural linear regression equation established could be applied for estim ating the stature of Southw est H an m ales.
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OBJECTIVE@#To establish regression model between craniofacial lines and body height by measuring craniofacial lines in Southwest Han males using CT and to accumulate data for the study of forensic anthropology.@*METHODS@#Head CT data of 273 Han males in Southwest were collected and 7 craniofacial lines were determined. Multiplanar reconstruction and volume rendering were performed by image post-processing software and the selected lines were measured. The relationship between each measuring indicator and body height was analyzed using SPSS 21.0 software. The regression equation of body height estimation was established and 50 samples were selected again and put into the mathematics models to verify its accuracy.@*RESULTS@#The linear regression equations of 7 lines were established (P < 0.05). The correlation coefficients of the unary linear regression equations were 0.190-0.439 and the standard errors of the estimate (SEE) were 4.597-5.023 cm. The correlation coefficients of the multiple linear regression equation were 0.494-0.524 and the SEE were 4.418-4.458 cm. The return tests showed that the highest ± 1SEE accuracy of the multiple regression equation: y = 83.959+3.589 x6+2.573 x2, were 30%; and the highest ± 2SEE accuracy of the multiple regression equation: y = 72.646+3.316 x6+1.586 x2+1.553 x4+2.211 x3, were 92%.@*CONCLUSION@#There is significant linear correlation between 7 selected lines and the stature in this study, and the plural linear regression equation established could be applied for estimating the stature of Southwest Han males.
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Humanos , Masculino , Pueblo Asiatico , Estatura , Cara/anatomía & histología , Antropología Forense , Cabeza/anatomía & histología , Procesamiento de Imagen Asistido por Computador , Modelos Lineales , Programas Informáticos , Tomografía Computarizada por Rayos XRESUMEN
People aged 18 years could be punished lightly or diminished criminal responsibility, even be spared the death sentence, which has important meaning in Chinese judicatory adjudication. The epiphysis of long bones from human limbs and the secondary sexual characteristics almost have developed completely before 18 years old. Clavicle epiphysis is one of the articular metaphysis which has a late epiphyseal closure. The recent studies in exploring the rule of clavicle epiphyseal by multi-imaging technology shows that the development of clavicle epiphysis has some value in age estimation of 18 years old. CT, especially thin-section CT, is widely used at present. However, thin-section CT scanning has great net radiation, which is not ethically acceptable if it is not for diagnosis and treatment. MRI is nonradioactive tomographic imaging and easy to evaluate, which is one of the future research directions in forensic age estimation using the medial clavicle. This paper summarizes the progress on the rule of clavicle epiphyseal closure, and analyzes and summarizes the feasibility of rule of clavicle epiphyseal closure applies on age estimation.
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Adolescente , Humanos , Determinación de la Edad por el Esqueleto , Pueblo Asiatico , Clavícula/fisiología , Muerte , Epífisis/fisiología , Antropología Forense , Imagen por Resonancia Magnética , Osteogénesis , Tomografía Computarizada por Rayos XRESUMEN
Objective To establish the linear regression equation between body height and com bined length of manubrium and mesosternum of sternum m easured by CTvolum e rendering technique (CT-VRT) in southw est H an population. Methods One hundred and sixty subjects, including 80 m ales and 80 fem ales w ere selected from southw est H an population for routine CT-VRT(reconstruction thickness 1 m m ) ex-am ination. The lengths of both manubrium and mesosternum w ere recorded, and the com bined length of manubrium and mesosternum was equal to the algebraic sum of them . The sex-specific linear regression equations between the com bined length of manubrium and mesosternum and the real body height of each subject w ere deduced. Results The sex-specific sim ple linear regression equations between the com bined length of manubrium and mesosternum (x3) and body height (y) w ere established (m ale:y=135.000+2.118x3 and fem ale:y=120.790+2.808x3).Both equations show ed statisticalsignificance (P<0.05) w ith a 100% predictive accuracy. Conclusion CT-VRTis an effective m ethod for m easurem ent of the index of sternum . The com bined length of manubrium and mesosternum from CT-VRTcan be used for body height estim ation in southw est H an population.
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OBJECTIVE@#To establish the linear regression equation between body height and combined length of manubrium and mesostenum of sternum measured by CT volume rendering technique (CT-VRT) in southwest Han population.@*METHODS@#One hundred and sixty subjects, including 80 males and 80 females were selected from southwest Han population for routine CT-VRT (reconstruction thickness 1 mm) examination. The lengths of both manubrium and mesosternum were recorded, and the combined length of manubrium and mesosternum was equal to the algebraic sum of them. The sex-specific linear regression equations between the combined length of manubrium and mesosternum and the real body height of each subject were deduced.@*RESULTS@#The sex-specific simple linear regression equations between the combined length of manubrium and mesostenum (x3) and body height (y) were established (male: y = 135.000+2.118 x3 and female: y = 120.790+2.808 x3). Both equations showed statistical significance (P < 0.05) with a 100% predictive accuracy.@*CONCLUSION@#CT-VRT is an effective method for measurement of the index of sternum. The combined length of manubrium and mesosternum from CT-VRT can be used for body height estimation in southwest Han population.