摘要:目的: 探討64排多層螺旋CT(MSCT)和血清淀粉樣蛋白A(serum amyloid A protein, SAA)聯合術前評估直腸癌在腫瘤分期診斷中的作用。 方法 :納入經根治術治療的直腸癌患者通過MSCT掃描進行評估,同時取患者靜脈血測量術前SAA水平,行MSCT分期與MSCT和SAA聯合分期以比較二者的診斷價值。 結果 :本研究納入患者121例。MSCT檢測T分期的準確度為851%。在評估淋巴結轉移方面,MSCT和SAA聯合分期的準確度為760%,明顯高于MSCT分期(595%, 〖WTBX〗P lt;0001)。MSCT正確判斷所有遠處轉移。同單一的MSCT檢測相比,MSCT和SAA聯合評估能顯著的提高術前TNM分期的準確率(785% vs. 636%,〖WTBX〗P =0011)。 結論 :MSCT聯合SAA檢測比單一的MSCT檢測顯著提高了直腸癌術前腫瘤分期和淋巴結轉移方面的準確度。這種新的術前評估方法的為腫瘤進展評估和術前治療決策提供了更加可靠的信息。Abstract: Objective: To determine the role of combinative assessment of 64 multislice spiral computer tomography (MSCT) and serum amyloid A protein (SAA) in preoperative rectal cancer staging. Methods : Enrolled consecutive rectal cancer patients undergoing curative surgery were evaluated by MSCT scan. Meanwhile venous blood specimens were taken to measure preoperative SAA concentration. Both MSCT staging and MSCT plus SAA staging were performed to compare with each other. Results : The study population consisted of 121 patients. The accuracy of T staging was 851% for MSCT. The accuracy in evaluating lymph nodes metastases was 760% for MSCT plus SAA compared with 595% for MSCT alone (〖WTBX〗P lt;0001). All the distant metastases were correctly detected by MSCT. The method combining MSCT with SAA led to significant improvement on preoperative TNM staging compared with MSCT alone (785% vs. 636%, 〖WTBX〗P =0011). Conclusion : MSCT plus SAA showed greater accuracy than MSCT alone in rectal cancer staging and lymph node metastases. This novel strategy of preoperative evaluation appears to provide more accurate information on tumor progression and preoperative therapy decisionmaking.
Objective To investigate clinical significance of serum VEGF-C level and C-erbB-2 protein expression in patients with breast cancer. Methods Sixty-two female patients with breast invasive ductal cancer and breast benign lesion were respectively selected. Serum VEGF-C level was detected by enzyme-linked immunosorbent assay (ELISA) before operation and at one month after operation, and C-erbB-2 protein expression in tissues of breast cancer was detected by immunohistochemistry. Then, the relationship between serum VEGF-C level and clinicopathologic characteristics and C-erbB-2 protein expressions wereas analyzed. Results The serum VEGF-C level before operation in breast cancer patients〔(279.65±17.34) pg/ml〕 was significantly higher than that in breast benign lesions patients 〔(167.26±12.15) pg/ml〕, P＜0.01. In breast cancer patients, the serum VEGF-C level before operation was higher than that at one month after operation 〔(209.45±15.23) pg/ml〕, P＜0.01. The serum VEGF level was related to tumor stage (P＜0.05) but not to patient age, tumor size, menopause status , lymph node metastasis or not and ER and PR expression (Pgt;0.05). The positive expression rate of C-erbB-2 protein in breast cancer patients (54.84%, 34/62) was significantly higher than that in breast benign lesion patients (11.29%, 7/62), P＜0.01. Moreover, the positive expression rate of C-erbB-2 protein in breast cancer patients with axilla lymph node metastasis (69.44%) was significantly higher than that without axilla lymph node metastases (34.62%), P＜0.05. The serum VEGF level increased with increasing expression intensity of C-erbB-2 protein and there was positive correlation between them (r=0.813，P＜0.05). Conclusions The serum VEGF-C level in breast cancer may be conducted as an assisted marker to differential diagnosis of breast tumor. C-erbB-2 is related to lymph node metastasis of breast cancer patients. There is synergistic effect between VEGF-C and C-erbB-2 in the lymph node metastasis way of breast cancer.
Objective To verify the association between admission serum phosphate level and short-term (<30 days) mortality of severe pneumonia patients admitted to intensive care unit (ICU) / respiratory intensive care unit (RICU). Methods Severe pneumonia patients admitted to the ICU/RICU of Quanzhou First Hospital Affiliated to Fujian Medical University from November 2019 to September 2021 were included in the study. Serum phosphate was demonstrated as an independent risk factor for short-term mortality of severe pneumonia patients admitted to ICU/RICU by logical analysis and receiver operator characteristic (ROC) curve. The patients were further categorized by serum phosphate concentration to explore the relationship between serum phosphate level and short-term mortality. Results Comparison of baseline indicators at admission between the survival group (n=54) and the non survival group (n=46) revealed that there was significant difference in serum phosphate level [0.9 (0.8, 1.2) mmol/L vs. 1.2 (0.9, 1.5) mmol/L, P<0.05]. Logical analysis showed serum phosphate was an independent risk factor for short-term mortality. ROC curve showed that the prediction ability of serum phosphate was close to pneumonia severity index (PSI). After combining serum phosphate with PSI score, CURB65 score, and sequential organ failure score, the predictive ability of these scores for short-term mortality was improved. Compared with the normophosphatemia group, hyperphosphatemia was found be with significantly higher short-term mortality (85.7% vs. 47.3%, P<0.05), which is absent in hypophosphatemia (25.8%). Conclusions Serum phosphate at admission has a good predictive value on short-term mortality in severe pneumonia patients admitted to the ICU/RICU. Hyperphosphatemia at admission is associated with a higher risk of short-term death.
ObjectiveTo explore the effect of Vitamin C (Vit C) on the apoptosis of human nucleus pulposus (NP) cells induced by tumor necrosis factor α (TNF-α) and serum deprivation. MethodsThe NP cells were isolated from patients undergoing spine corrective operation by collagenase trypsin. The experiment was divided into 3 groups:Vit C group (group A), TNF-α group (group B), and serum deprivation group (group C). Group A was reassigned to A1 subgroup (basic medium), A2 subgroup (100 μg/mL Vit C), and A3 subgroup (200 μg/mL Vit C). Group B was reassigned to B0 subgroup (control group), B1 subgroup (100 ng/mL TNF-α), B2 subgroup (100 μg/mL Vit C+100 ng/mL TNF-α), and B3 subgroup (200 μg/mL Vit C+100 ng/mL TNF-α). Group C was reassigned to C0 subgroup (Control group), C1 subgroup (2% FBS), C2 subgroup (2%FBS+100 μg/mL Vit C), and C3 subgroup (2% FBS+200 μg/mL Vit C). After C1 subgroup (2% FBS), C2 subgroup (2%FBS+100 μg/mL Vit C), and C3 subgroup (2% FBS+200 μg/mL Vit C). After application of 100 μg/mL or 200 μg/mL Vit C for 24 hours, NP cells were stimulated by TNF-α and serum deprivation, then the apoptosis rate of NP cells was detected by a flow cytometry, and the gene expressions of the extracellular matrix of NP cells (collagen type Ⅰ, collagen type Ⅱ, aggrecan, and Sox9) and apoptosis related genes (p53, FAS, and Caspase 3) were detected by real-time fluoroscent quantitative PCR. ResultsGroup A:Vit C could significantly reduce the apoptosis rate and gene expressions of p53, FAS, and Caspase 3 of NP cells in A2 and A3 subgroups when compared with A1 subgroup (P<0.05), but there was no significant difference between A2 subgroup and A3 subgroup (P>0.05); Vit C could promote the expressions of the extracellular matrix (collagen type Ⅰ, collagen type Ⅱ, aggrecan, and Sox9) of NP cells in a concentration dependent manner (P<0.05). Group B:TNF-α significantly increased the apoptosis rate and the gene expressions of p53, FAS, and Caspase 3 in B1 subgroup when compared with B0 subgroup (P<0.05); however, Vit C significantly increased the apoptosis rate and the gene expressions in B2 subgroup, and significantly decreased them in B3 subgroup when compared with B1 subgroup (P<0.05). Group C:2% FBS significantly increased the apoptosis rate of NP cells and significantly reduced the gene expressions of p53, FAS, and Caspase 3 in C1 subgroup when compared with C0 subgroup (P<0.05); Vit C could significantly reduce the apoptosis rate and gene expressions of p53, FAS, and Caspase 3 in C3 subgroup, but it could significantly increase them in C2 subgroup when compared with C1 subgroup (P<0.05). ConclusionVit C can promote the synthesis and secretion of extracellular matrix of NP cells. 200 μg/mL Vit C may delay the apoptosis induced by TNF-α and serum deprivation, indicating the potential therapeutic effect of Vit C on intervertebral disc degeneration.
Prostate cancer is a common disease in the USA and Europe, with a gradually increasing incidence in China, and presents a significant health burden for older men. The lack of modifiable risk factors has made early detection as a strategy to reduce mortality. Current methods of screening involve the measurement of serum prostate-specific antigen (PSA) and digital rectal examination followed by biopsy. With PSA screening evidence of level I absent, the evidence on the use of PSA as a screening test is still highly controversial. Furthermore, there is controversy over whether screen-detected lesions will become clinically significant. There are three major treatment options for localized disease: radical prostatectomy, radical radiotherapy and monitoring with treatment if required. There is no evidence of randomized controlled trial (RCT) to suggest a survival advantage of any of these treatments. Opinions about the related benefits and risks of screening vary widely. In the absence of RCT of benefit for screening, many now suggest “informed consensus” screening, which encourages a discussion between the patient and his physician with both sides informed of all of the issues.
目的探討血清膽紅素升高在急性闌尾炎壞疽、穿孔中的診斷價值。 方法回顧性分析2011年6月至2013年8月期間我院住院行手術治療的急性闌尾炎患者的臨床病理資料，比較多種指標診斷急性復雜闌尾炎的準確性。 結果復雜闌尾炎患者血清總膽紅素（STB）水平明顯高于非復雜闌尾炎患者（P＜0.001）。STB升高診斷復雜闌尾炎的敏感性及特異性分別為33.3%和86.2%，而血清直接膽紅素(SDB）升高（≥6.65μmol/L）診斷復雜闌尾炎的敏感性及特異性分別為78.1%和63.5%。系統炎癥反應（SIRS）評分與STB聯合診斷具最佳診斷效能，受試者操作特征曲線下面積為0.741，而血清白細胞計數（特異性40.7%）診斷準確性相對較低。 結論SDB升高診斷急性闌尾炎壞疽、穿孔的準確性較佳，STB與SIRS評分聯合診斷可作為早期鑒別診斷復雜闌尾炎的參考指標。
Objective To investigate the clinical significance of the level of serum amylase and serum IgA and total IgE in henoch-schonlein purpura patients with gastrointestinal involvement (also known as "Henoch purpura "). Methods Levels of serum amylase and serum IgA and total IgE in henoch-schonlein purpura patients with or without abdominal pain or patients with acute abdominal pain were compared. Results The average level (180.3 ± 15.8 IU) of serum amylase of Henoch purpura patients was significantly higher than HSP patients without abdominal pain and acute abdominal pain patients (F=32.214, P=0.009); Ratio of cases of increased level of serum IgA in henoch purpura abdomen patients was 44.2%, and there was no significant difference with HSP patients without abdominal pain. But ratio of two groups was respectively higher than the acute abdominal pain patients group (χ2=13.73, P=0.001); Ratio of cases of increased level of serum IgE in Henoch purpura abdomen patients accounted for 40.4%, but there was no significant difference among the three group (χ2=1.80，P=0.41). Conclusion Levels of serum amylase increase and serum IgA increase conduce to diagnose HSP patients with the onset of abdominal pain, and serum total IgE has little significance.
Objective To investigate the effects of a mixed bacterial lysate (OM-85 BV) on lung function and serum IgE in asthmatic mice under acute attack, and to explore the therapeutic effect of OM-85 BV on acute attack and the application value of OM-85 BV in non-acute attack. Methods A total of 30 SPF Kunming mice aged 4 to 6 weeks were randomly divided into 3 groups, namely a blank control group (Group A), an asthma model group (Group B), and an OM-85 BV intervention group (Group C). The mice in groups B and C were sensitized by intraperitoneal injection of ovalbumin on day 1, 8 and 15, respectively. From day 22, the asthma model was stimulated by inhalation of 5% ovalbumin every day for 30 min for 5 consecutive days. The mice in group C were treated with OM-85 BV dissolved in normal saline from day 1, and each mouse was gavaged continuously for 10 days. The intraperitoneal injection, intragastric administration and aerosol inhalation reagent of mice in group A were all replaced by normal saline, while the intragastric administration of mice in group B was replaced by normal saline. One hour after the last stimulation, the mice were anesthetized, their lung function was measured, blood was collected from the eyeballs and then they were sacrificed, and the blood was centrifuged and the serum was separated and stored. Hematoxylin and eosin staining was used for pathological examination. Serum IgE was determined by enzyme-linked immunosorbent assay. Results Compared with group A, forced vital capacity in 0.15 second (FEV0.15), FEV0.15/forced vital capacity (FVC) and peak expiratory flow (PEF) of mice in group B were significantly decreased. The lung function of group C was improved compared with group B. In group B, the pathological manifestations were dysplasia and collapse of bronchial epithelium, infiltration of inflammatory cells, mainly lymphocytes and eosinophils, a small amount of mucus and shed epithelial cells in the tracheal lumen, and significant thickening of airway wall. The asthma mouse model was well established. The pathological manifestations of airway in group C were less severe than those in group B, the thickness of airway wall was reduced, and the inflammatory cells were also significantly reduced. The serum IgE concentration in groups B and C increased, and the IgE level in group C decreased significantly compared with group B. The differences were statistically significant (all P<0.05). Conclusions Exogenous administration of OM-85 BV in asthmatic mice can effectively reduce the concentration of serum IgE, alleviate airway inflammation, reduce eosinophil infiltration, and improve the pulmonary function performance of asthmatic mice during acute attack, showing that FEV0.15/FVC, FEV0.15 and PEF indicators are significantly improved. OM-85 BV can alleviate the symptoms of bronchial asthma in the acute attack of mice, improve the physiological function of the lung during the acute attack, inhibit airway inflammation, and have certain application value in the stable asthma control.
Objectives To investigate the correlation between blood total cholesterol (TC) and prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) and to provide references for clinical treatment and prognosis assessment. Methods We included 232 ISSNHL patients with total deafness in Wenzhou Central Hospital from June 2015 to March 2017 using a prospective cohort design. Recording information including age, gender, hypertension, diabetes mellitus, vertigo, level of blood total cholesterol (TC), level of triglyceride (TG), level of low-density lipoprotein (LDL-C) and LDL/HDL ratio (LDL-C/HDL-C) were collected. Correlation between the prognosis of ISSNHL and blood total cholesterol were analyzed by univariable and multivariable logistic regression analysis. Results The clinical effective rate of patients with TC ranging from 5.2 mmol/L to 6.2 mmol/L was higher than that of patients with TC lower than 5.2 mmol/L (univariable: RR=6.49, 95%CI 3.16 to 13.30, P<0.001; multivariable-adjusted covariates: RR=6.15, 95%CI 2.66 to 14.3,P<0.001) with significant difference. No significant difference was found between patients with TC lower than 5.2 mmol/L and patients with TC higher than 6.2 mmol/L (univariable: RR=1.02, 95%CI 0.52 to 2.00,P=0.960; multivariable-adjusted covariates: RR=1.61, 95%CI 0.55 to 4.73, P=0.386). Gender-specific analysis showed for both male and female groups, the effective rates of patients with TC ranging from 5.2 mmol/L to 6.2 mmol/L were significantly higher than those of patients with TC lower than 5.2 mmol/L. There was no significant difference between patients with TC lower than 5.2 mmol/L and patients with TC higher than 6.2 mmol/L (P>0.05) in either male group or female group. Conclusion The current study suggests that patients with levels of TC ranging from 5.2 mmol/L to 6.2 mmol/L predicts the best prognosis.