临床诊疗

辅助内分泌治疗对乳腺癌患者血脂及肝功能水平的影响

Influence of Adjuvant Endocrine Therapy to Blood Fat and Liver Function of Breast Cancer Patients

:59-61
 
目的 动态观察乳腺癌患者辅助内分泌治疗5年后的血脂及肝功能水平的变化,探求辅助内分泌治疗与高脂血症及脂肪肝发病率的关系。方法 56例乳腺癌患者实行辅助内分泌治疗,术后随访5年动态抽血测定其总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)及谷草转氨酶(AST)、谷丙转氨酶(ALT)、直接胆红素(DBIL)、总胆红素(TBIL)等参数的变化,B超监测其肝脏变化。结果 经过2年内分泌治疗TG由(1.203±0.723)mmol/L上升至(1.701±1.271)mmol/L,5年内分泌治疗后TG降至(1.389±0.706)mmol/L。经过2年内分泌治疗LDL由(2.497±0.990)mmol/L上升至(2.950±0.984)mmol/L,5年内分泌治疗后LDL为(2.867±0.886)mmol/L。结论 辅助内分泌治疗2年会导致其TG和LDL的升高,5年随访仅发现LDL升高,辅助内分泌治疗会增加乳腺癌患者诱发心血管疾病的风险。
论著

连续护理在提高乳腺癌保乳患者生存质量中的应用效果分析

The effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy

:56-58
 
目的 探讨连续护理在提高乳腺癌保乳患者生存质量中的应用效果,号召我院为病人提供持续性、连续性护理开展APN排班。方法 随机抽取2011年1月—2014年1月我院收治的117例乳腺癌患者的临床资料。观察两组患者术后生存质量、焦虑情况、抑郁情况、术后上肢水肿情况。结果 两组患者术后1周生存质量比较,差异无统计学意义(P>0.05);观察组术后1个月、3个月、6个月、1年生存质量高于对照组,差异有统计学意义(P<0.05)。两组患者术后1周焦虑情况比较,差异无统计学意义(P>0.05);观察组术后1个月、3个月、6个月、1年忧郁情况优于对照组,差异有统计学意义(P<0.05)。观察组患者术后上肢水肿情况优于对照组,差异有统计学意义(P<0.05)。结论 连续护理在提高乳腺癌保乳患者生存质量中的应用效果较好,能够改善患者术后生存质量、焦虑抑郁情况、术后上肢水肿情况,值得临床推广。
Objective To explore the effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy. Methods 117 cases of patients with breast cancer were randomly divided into observation group(59 cases) and control group(58 cases). The control group were cared by routine postoperative care, including health education. On the basis of the control group, the observation group were cared by continuous nursing intervention, including cognitive intervention, psychological intervention, social support, life care, functional exercise, the prevention of complications and discharge instruction. The quality of life, anxiety situation, depression amd upper limb edema were compared in the two groups. Results There has no significant difference on the quality of life after 1 week in the two groups(P>0.05); The quality of life after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). There has no significant difference on the anxiety situation after 1 week in the two groups(P>0.05); The anxiety situation after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). The depression situation after 1 week, 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). The upper limb edema situation for the observation group were better than the control group(P<0.05). Conclusion The effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy is good. It can improve the quality of life, situations of anxiety, depression and upper limb edema. It is worthy of clinical promotion.
论著

子宫内膜微腺体癌的临床病理特征与鉴别诊断

Clinicopathological features and differential diagnosis of endometrial microglandular adenocarinoma

:9-11
 
目的 探讨子宫内膜微腺体癌的临床病理特征、诊断及鉴别诊断。方法 对1例首诊误诊为子宫颈微腺体增生的子宫内膜微腺体癌病例进行临床、病理组织学及免疫组织化学特征的观察及总结,同时进行相关文献复习。结果 本例患者年龄61岁,因绝经后阴道不规则流血1年就诊,B超提示子宫内膜不规则增厚,并行分段诊刮术,先后两次诊刮标本光镜下均见黏液性柱状上皮呈乳头状及网格状结构,细胞轻度异型,核分裂罕见,间质内大量中性粒细胞浸润伴腺上皮内“微脓肿”形成;免疫组化示:上皮成分P16弥漫强(+),CEA小灶(+),Vimentin弥漫(+),ER约90%(+,中-强),PR约90%(+,弱),Ki-67约3%(+),间质细胞CD10(+)、CD34(-)。结论 子宫内膜微腺体癌是一种极为罕见的子宫内膜黏液腺癌,其组织学形态与子宫颈良性病变微腺体增生十分相似,易于混淆,但通过免疫组化检查及详细地临床病史资料收集、分析,可以与其鉴别,从而做出正确地诊断。
Objective To investigate clinical and histopathological features, dignosis and differential diagnosis of the endometrial microglandular adenocarinoma (MGA). Methods The clinical and pathological features of microglandular adenocarinoma in a patient were observed. Immunohistochemical staining and literature review were also used. Results In the case, the age of patient was 61 years. Clinical manifestation was vaginal irregular bleeding for 1 year. Type-B ultrasound suggested endometrium was irregular thickening. Histologically, it was mainly composed of irregular shape, closely spaced small glands, and glandular cells was mild atypical. Mitosis was rarely observed. The endometrial stromata between gland were rare, but neutrophil were much observed with the formation of neutrophil microabscess in the glandular epithelium. Immunohistochemical study showed neoplastic cells were diffuse and strongly positivity for P16, diffuse positivity for vimentin, focally positive for CEA. ER and PR expression was found in approximately 90% tumor cells. The index of Ki-67 was about 3%. Interstitial cells were positivity for CD10, negativity for CD34. Conclusion The microglandular adenocarcinoma is a rare endometrial adenocarcinoma. It can be differentiated from cervical microglandular hyperplasia(MGH) and cervical mucinous adenocarcinoma by immunohistochemistry and morphological characteristics.
论著

SEMA3B基因真核表达载体的构建及对肺癌细胞恶性生物学行为的影响

Construction of eukaryotic expression vector of SMEA3B and the functional research on malignant biological characteristics of lung cancer cells

:4-8
 
目的 构建抑癌基因SEMA3B真核表达载体pcDNA3.1-SEMA3B,并检测其对肺癌A549细胞恶性生物学行为的影响。方法 应用PCR扩增SEMA3B全长cDNA片段,构建真核表达载体pcDNA3.1-SEMA3B。克隆PCR、双酶切法、基因测序验证过表达载体构建成功。将pcDNA3.1-SEMA3B真核表达载体和空载体pcDNA3.1分别转染入A549细胞中,应用qRT-PCR、Western blot检测SEMA3B mRNA、蛋白表达水平的变化;MTS法检测细胞增殖;流式细胞仪检测细胞凋亡、细胞周期;克隆形成实验检测细胞集落形成能力。结果 SEMA3B基因扩增片段与预测片段一致,克隆成功,且测序鉴定证实真核表达载体构建成功。转染pcDNA3.1-SEMA3B真核表达载体可上调SEMA3B mRNA、蛋白表达水平,且可抑制A549细胞的增殖,诱导凋细胞亡,细胞被阻滞在G1期,抑制细胞集落形成能力。结论 成功构建了SEMA3B基因真核表达载体,抑癌基因SEMA3B在肺癌恶性生物学进程中可能发挥重要作用。
Objective To construct the eukaryotic expression vector of the cancer suppressor gene, SEMA3B, and research the effects on malignant biological behavior of lung cancer A549 cells. Methods By reverse transcriptase-polymerase chain reaction (RT-PCR), the full length SEMA3B gene was amplified and then was inserted into pcDNA3.1. The recombinant plasmid pcDNA3.1-SEMA3B was confirmed correctly through double enzyme digestion and PCR identification, which was transfected into lung cancer A549 cells by lipid media transfection. The untransfected A549 and A549 transfected with pcDNA3.1 were used as controls. SMEA3B gene was detected by qRT-PCR and western blot. MTS assay, flow cytometry, and colony formation test were performed to evaluate the effect of overexpression of SEMA3B gene on A549 cell proliferation, apoptosis, cell cycle, and colony forming ability. Results The amplied fragment of SEMA3B gene by PCR was consistent with the anticipated result, the SEMA3B gene was cloned successfully. And the recombinant plasmid pcDNA3.1-SMEA3B was constructed successfully through gene sequence identification. After transfection of pcDNA3.1-SEMA3B, SEMA3B mRNA and protein expression levels were raised, and overexpression of SEMA3B gene in A549 cells significantly inhibited the proliferation of A549 cells, induced apoptotic cell death, blocked cell cycle in the G1 phase, and suppressed cell colony-forming ability. Conclusion The recombinant pcDNA3.1-SEMA3B is constructed successfully. SEMA3B gene can significantly inhibit the malignant biological behavior of lung cancer A549 cells.
论著

Snail调控乳腺癌细胞中MTDH表达机制的研究

Study on the regulate mechanism of Snail to the expression of MTDH in breast cancer cells

:1-3
 
目的 分析乳腺癌细胞中Snail与MTDH基因的作用,明确Snail是否通过结合于MTDH的启动子区域促进乳腺癌转移。方法 克隆、转染Snail基因至乳腺癌细胞,观察过表达Snail的乳腺癌细胞中MTDHmRNA及蛋白表达的变化;再使用免疫共沉淀法检测Snail与MTDH基因的共作用。结果 转染Snail基因进入乳腺癌MDA-MB-435细胞后,转染组、空白组和对照组中MTDHmRNA的表达水平分别为1.61±0.22、1.02±0.18、0.99±0.20,转染组高于空白组和对照组,差异有统计学意义(P<0.05),而后两组表达无差异(P>0.05);Westren blot检测结果显示,Snail可促进MTDH蛋白的表达;免疫共沉淀显示,Snail与MTDH在细胞内存在相互结合作用。结论 Snail在乳腺癌细胞中可通过结合于MTDH基因的启动子区域,促进MTDHmRNA转录及相关蛋白的表达,从而导致乳腺癌转移。
Objective To investigate the function of Snail to MTDH gene in breast cancer cells. Methods We observed the changement of MTDHmRNA and protein expression in breast cancer cell line MDA-MB-435 after transfected with Snail gene. Then, we used co-immunoprecipitation to determine the domain of Snail and MTDH binding in vitro. Results After transfected with Snail gene into MDA-MB-435 cell, the expression levels of MTDHmRNA in transfection group, blank group and control group were 1.61±0.22,1.02±0.18,0.99±0.20. The level of transfection group was significantly higher than the other groups(P< 0.05). Western blot showed that the expression of MTDH protein can be promoted by Snail. Co-immunoprecipitation showed that Snail and MTDH are binding interactions in breast cancer cell line MDA-MB-43. Conclusion Snail can promote transcription and expression of MTDH in breast cancer cells by binding to the promoter region of the MTDH gene resulting in metastasis of breast cancer.
论著

肝癌根治术后恶心呕吐现状及影响因素分析

Analysis of the status and influencing factors of nausea and vomiting after radical resection of liver cancer

:1245-1250
 
目的 探讨肝癌根治术后恶心呕吐现状及影响因素。方法 选取2022年5月—2024年5月天津市第二人民医院收治的70例肝癌患者进行回顾性分析,所有患者均行肝癌根治术,分析其术后恶心呕吐情况。并依照恶心呕吐发生情况进行分组,将30例术后发生恶心呕吐的患者分为观察组,其余40例患者为对照组。对比两组患者临床病理特征及围术期指标。并建立Logistic回归模型以术后恶心呕吐为因变量分析肝癌患者手术切除术后恶心呕吐的影响因素。结果 肝癌患者手术切除术后恶心呕吐发生率为42.86%(30/70),其中Ⅰ度14例(20.00%)、Ⅱ度10例(14.29%)、Ⅲ度4例(5.71%)、Ⅳ度2例(2.86%);观察组与对照组性别、体质量指数(BMI)、病理类型、临床分期、术前禁食时间对比差异无统计学意义(P>0.05),观察组与对照组年龄及是否化疗情况对比差异有统计学意义(P<0.05);观察组与对照组手术时间、术后VAS评分、麻醉方式、术后合并其他并发症情况对比差异无统计学意义(P>0.05),观察组与对照组肝门阻断时间、术中失血量及术后腹胀情况对比差异有统计学意义(P<0.05);年龄、是否化学治疗、术中失血量、术后腹胀情况为肝癌患者手术切除术后恶心呕吐的影响因素(P<0.05)。结论 肝癌患者手术切除术后恶心呕吐发生率较高,且年龄、是否化疗、术中失血量及术后腹胀情况可能为恶心呕吐发生的影响因素,针对此类患者高风险患者需及时采取相关措施进行干预,预防患者术后恶心呕吐情况及减轻严重程度。
Objective To explore the status and influencing factors of nausea and vomiting after radical resection of liver cancer. Methods A retrospective analysis was conducted on 70 liver cancer patients admitted to the Second People’s Hospital of Tianjin from May 2022 to May 2024. All patients underwent radical surgery for liver cancer,and their postoperative nausea and vomiting conditions were analyzed. According to the occurrence of nausea and vomiting, 30 patients who experienced nausea and vomiting after surgery were divided into an observation group, and the remaining 40 patients were divided into a control group. The clinical and pathological characteristics as well as perioperative indicators between two groups of patients were compared. A logistic regression model was established to analyze the influencing factors of postoperative nausea and vomiting in liver cancer patients after surgical resection,with postoperative nausea and vomiting as the dependent variable. Results The incidence of postoperative nausea and vomiting in liver cancer patients was 42. 86%(30/70), including 14 cases of grade I, accounting for 20. 00%, 10 cases of grade II, accounting for 14. 29%, four cases of grade III,accounting for 5. 71%, and two cases of grade IV,accounting for 2. 86%. There were no significant differences in gender,body mass index(BMI), pathological type,clinical stage,and preoperative fasting time between the observation group and the control group(P>0. 05). However, there were significant differences in age and chemotherapy status between the observation group and the control group(P<0. 05). There were no significant differences in the operation time,postoperative VAS score,anesthesia method and postoperative complications between the observation group and the control group(P>0. 05), but with differences in the portal block time,intraoperative blood loss and postoperative abdominal distension between the observation group and the control group(P<0. 05). Age, chemotherapy, intraoperative blood loss, and postoperative abdominal distension were independent influencing factors for postoperative nausea and vomiting in liver cancer patients undergoing surgical resection(P<0. 05). Conclusions The incidence of nausea and vomiting after surgical resection in liver cancer patients is relatively high, with age, chemotherapy, intraoperative blood loss, and postoperative abdominal distension may be influencing factors for nausea and vomiting. Therefore, relevant measures should be taken in a timely manner to intervene in high-risk patients to prevent postoperative nausea and vomiting and reduce its severity.
论著

窄带成像结合放大内镜和超声内镜评估在早期结直肠癌内镜下治疗前的价值

Application value of magnifying endoscopy combined with narrow band imaging and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer

:957-962
 
       目的   分析早期结直肠癌内镜下治疗前行窄带成像结合放大内镜 (ME-NBI)和超声内镜技术的评估价值。方法   采用回顾性分析方法,以2021年1月— 2023 年 12月中山市第五人民医院收治的102例早期结直肠癌患者为观察对象,所有患者均接受内镜下黏膜切除术(EMR)或内镜黏膜下剥离术(ESD)治疗,根据内镜下治疗前是否进行ME-NBI和超声内镜检查分为研究组与对照组各51例。比较两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理特征;比较两组治疗时间、ESD治疗后非治愈性切除发生率、治愈性切除率、并发症发生情况及再次ESD或外科手术治疗率。结果   两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理比较差异均无统计学意义(P>0.05)。研究组中37例行ESD治疗,治疗时间为(120.6±140.3)min,12例行EMR治疗,治疗时间为(11.6±9.3)min,有2例不符合内镜下治疗指征,转外科手术治疗。对照组有38例行ESD治疗,治疗时间为(128.8±144.5)min,13例行EMR治疗,治疗时间为(12.5±9.5)min,两者治疗时间比较差异均无统计学意义(P>0.05)。研究组非治愈性切除率为7.84,低于对照组27.45;治愈性切除率为88.24,高于对照组72.55;研究组ESD手术并发症为8.11%,低于对照组31.58;ESD或外科手术率为6.12,低于对照组25.49P<0.05),结论  ME-NBI和超声内镜对早期结直肠癌患者行内镜下治疗指征评估更准确,可提高治愈性切除率
       Objective  To  study the application value of magnifying endoscopy combined with  narrow  band imaging (ME-NBI)and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer.Methods  A retrospective analysis was carried out on  102  patients with early-stage colorectal cancer who were admitted to Zhongshan Fifth People’s Hospital from January 2021 to December 2023.All patients were treated with endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESO).The patients were divided into study group(51 cases)and control group(51 cases)according to whether ME-NBI and ultrasonic endoscopy was performed before endoscopic treatment or not.The patient age,sex,volume of tumor,location of tumor and pathological result of the tumor were compared between two groups.Time for treatment,curative resection rate,non-curative resection rate and the complication incidence of ESD,incidences of second ESD or surgery were compared between the two groups.Results  There were no statistical differences in age,sex,volume of tumor,location of tumor and pathological result of the tumor(P>0.05).In the study group,37 patients received ESD treatment,operation time was(120.6±140.3)minutes,and 12 patients received EMR treatment,operation time was(11.6±9.3)minutes,two cases were transferred to surgery due to endoscopic ultrasonography combined with magnifying endoscopy showed that they did not meet the indications for ESD treatment.In the control group,38 patients received ESD treatment,operation time was(128.8±144.5)minutes,13 patients received EMR treatment,operation time was(12.5±9.5)minutes.There was no significant difference in treatment duration between the two groups.The non-curative resection rate of the study group was 7.84%,which was significantly lower than that in the control group(27.45%),and the curative resection rate(88.24%)was significantly higher than that in the control group(72.55%).The complications of ESD surgery in the study group were 8.11%,lower than 31.58% in the control group.The rate of second ESD or surgery was 6.12%,lower than 25.49% in the control group(P<0.05).Conclusions  ME-NBI and endoscopic ultrasound are more accurate in the evaluation of endoscopic indications for early colorectal cancer patients,and can improve the curative resection rate.
论著

贝伐珠单抗联合化疗对晚期结直肠癌患者 MSH2、MLHI、MSH6 和 PMS2 水平影响

The effect of bevacizumab combined with chemotherapy on the levels of MSH2,MLHI,MSH6 and PMS2 in patients with advanced colorectal cancer

:809-814
 
       目的   分析贝伐珠单抗与化疗对晚期结直肠癌患者4种错配修复蛋白(MSH2、MLHI、MSH6、PMS2)水平影响。方法   选择2022年1月—2024年1月江苏省宿迁市中医院肿瘤科102例晚期结直肠癌患者,按抽签法分成两组,即化疗组及联合组,各51例。化疗组应用FOLFOX(亚叶酸钙+奥沙利铂+氟尿嘧啶)方案进行化疗,联合组采取贝伐珠单抗联合FOLFOX方案治疗。对比其肿瘤控制效果、免疫功能及MSH2、MLHI、MSH6和PMS2水平变化,并对比组间不良反应发生率。结果   联合组客观缓解率、疾病控制率高于化疗组(P<0.05);治疗后联合组患者CD4+ 、CD3+ 、CD8+ 、和CD4+ /CD8+数值高于化疗组,且两组治疗后均低于治疗前(P<0.05);治疗后两组患者MSH2、MLHI、MSH6和PMS2缺失率对比无统计学意义(P>0.05),但其阳性、阴性表达情况对比差异有统计学意义,联合组MSH2、MLHI、MSH6和PMS2阳性率低于化疗组(P<0.05);两组不良反应发生率对比差异无统计学意义(P>0.05)。结论   对晚期结直肠癌在化疗基础上增加贝伐珠单抗抗肿瘤效果显著,改善其免疫功能,虽无法改善患者错配修复蛋白缺损,但可辅助降低其阳性率,且不影响安全性。
       Objective  To analyze the effects of bevacizumab and chemotherapy on the levels of four mismatch  repair proteins(MSH2,MLHI,MSH6,PMS2)in patients with advanced colorectal cancer.Methods  A total of 102 patients with advanced colorectal cancer from the Oncology Department of Suqian Traditional Chinese Medicine Hospital in  Jiangsu Province from January 2022 to January 2024 were selected,and were divided into two groups according to the drawing method,namely the chemotherapy group and the combination group,with 51 patients in each group.The chemotherapy group received FOLFOX(calcium folinate+oxaliplatin+fluorouracil)regimen for chemotherapy,while the combination group received bevacizumab combined with FOLFOX regimen for treatment.Tumor control effect,immune function,and changes in MSH2,MLHI,MSH6,and PMS2 levels,and its incidence of adverse reactions were compared.Results  The objective remission rate and disease control rate of the combined group were higher than those of the chemotherapy group(P<0.05).After treatment,the CD4+ ,CD3+ ,CD8+ and CD4+ /CD8+ values in the combination group were higher than those in the chemotherapy group,and those after treatment were lower than those before treatment in both groups(P<0.05).After treatment,there were no significant differences in the deletion  rates of MSH2,MLHI,MSH6,and PMS2 between the two groups of patients(P>0.05),but there was a significant difference in their positive and negative expression.The positive rates of MSH2,MLHI,MSH6,and PMS2 in the combination group were lower than those in the chemotherapy group(P<0.05).There was no significant difference in the incidence of adverse  reactions between the two groups(P>0.05).Conclusions  Adding bevacizumab on the basis of chemotherapy has a significant anti-tumor effect on advanced colorectal cancer,improving its immune function.Although it cannot improve the mismatch  repair protein defect in patients,it can assist in reducing its positivity rate and has high safety.
论著

钝性分离扩皮法与常规扩皮法在乳腺癌术后患者 PICC 置管中的应用效果

Application effect of blunt separating skin expansion and conventional skin expansion in PICC catheterization for patients with breast cancer after operation

:798-803
 
       目的  对比分析钝性分离扩皮法与常规扩皮法对乳腺癌术后患者经外周静脉置入中心静脉导管(PICC)置管应用效果。方法  选取2022年4月—2024年4月在天津肿瘤医院空港医院接受治疗的120例乳腺癌术后PICC置管患者,依据随机数字表法进行分组处理。对照组60例给予常规扩皮法,观察组60例给予钝性分离扩皮法,对比两组患者扩皮结果。结果  观察组患者满意度为96.67%,对照组患者满意度为86.67%(χ 2 =3.927,P=0.048);观察组患者的穿刺点血液浸湿面积分别为穿刺后即刻(0.87±0.14)cm2 、1 d后(4.89±0.94)cm2 以及3 d后(0.21±0.05)cm2 ,均低于对照组的(2.74±0.63)(9.89±2.04)(0.44±0.12)cm2 ,对比差异有统计学意义(t=22.444、17.243、13.704,P<0.05);观察组患者一次性送鞘成功率为98.33%,对照组患者一次性送鞘成功率为88.33%,观察组高于对照组(χ 2 =4.821,P=0.028);扩皮前两组患者的VAS评分无差异(P>0.05),扩皮后两组患者的VAS评分均降低,且观察组(1.75±0.54)分低于对照组(3.89±1.22)分,对比差异有统计学意义(t=12.425,P<0.001);观察组患者不良事件发生率为5.00%,对照组患者不良事件发生率为16.67%,观察组患者不良事件发生率低于对照组(χ 2 =4.227,P<0.05)。结论  钝性分离扩皮法能够降低穿刺点血液浸湿面积及不良事件发生率,提高一次性送鞘成功率,减轻患者疼痛感,提高患者满意度。
       Objective  To analyze the effect of blunt separating skin expansion and conventional skin expansion in PICC catheterization of patients after breast cancer surgery.Methods  From April 2022 to April 2024,120 patients with postoperative PICC catheterization for breast cancer were selected and grouped according to the random number table method.Sixty patients in the control group received conventional skin expansion,and 60 patients in the observation group  received blunt separation skin expansion,which the results of the two groups were compared.Results  The patient satisfaction was 96.67% in the observation group,86.67% in the control group(χ 2 =3.927,P=0.048,P<0.05).In the observation group,the blood immersion area after catheterization,after 1 d and 3 d were(0.87±0.14),(4.89±0.94),(0.21±0.05)cm2 ,lower than those of the control group [(2.74±0.63)(9.89±2.04)(0.44±0.12)cm2 ],the comparative difference was statistically significant(t=22.444,17.243,13.704,P<0.05).The success rate of disposable sheath delivery in the observation group was 98.33%,which was higher than 88.33% in the control group(χ 2 =4.821,P=0.028<0.05).There was no difference in VAS scores between the two groups before the intervention(P>0.05),VAS scores decreased in both groups after the intervention,the score of the observation group(1.75±0.54)was lower than that of the control group(3.89±1.22),the difference was statistically significant(t=12.425,P<0.001).The incidence of adverse events in the observation group was 5.00%,and in the control group was 16.67%,which difference was significant(χ 2 =4.227,P<0.05).Conclusions  Blunt separating skin expansion can  reduce the area of blood immersion and the incidence of adverse events,improve the success rate of disposable sheath delivery,reduce patient pain,improve patient satisfaction,and have significant clinical application value.
论著

基于生物信息学分析 TRIB2 与结肠癌预后和免疫浸润相关性

Correlation of TRIB2 expression with prognosis and immune infiltration in colon cancer based on bioinformatics

:766-774
 
       目的  探讨TRIB2在结肠癌中的表达水平及与预后及免疫浸润之间的关系。方法  TIMER数据库分析TRIB2在泛癌种中的表达;TCGA、GSE17538下载结肠癌患者RNA-seq数据和临床信息,评估其与临床病理特征的相关性;生存曲线、单因素和多因素Cox分析探讨TRIB2与预后的相关性,并构建列线图;对TRIB2进行差异基因的富集分析;分析TRIB2表达水平与免疫细胞浸润、免疫检查点、肿瘤突变负荷(TMB)以及免疫治疗敏感性之间的相关性。结果  TRIB2在结肠癌组织中高表达(P<0.05);CMS1结肠癌患者TRIB2 mRNA表达水平最高;TRIB2是结肠癌患者的独立预后因素(单因素Cox回归分析:HR=1.397,95%CI:1.100~1.774,P=0.006;多因素Cox回归分析:HR=1.502,95%CI:1.158~1.947,P=0.002);TRIB2与免疫细胞的浸润密切相关,并且与免疫检查点分子表达水平以及TMB正相关(r=0.39,P<0.001);TRIB2的表达水平与免疫检查点抑制剂的疗效相关。结论  TRIB2在结肠癌中高表达且与结肠癌患者预后差和免疫微环境密切相关。
       Objective  To explore the expression of TRIB2 in colon cancer and its relationship with prognosis and immune cell infiltration.Methods  TIMER database was used to analyse the expression of TRIB2 in pan-cancer.RNA-seq  data and clinical information of colon cancer patients were downloaded from TCGA and GSE17538 to assess the correlation between TRIB2 with clinicopathological features.Survival curves,univariate and multivariate COX regression analysis were performed to explore the correlation between TRIB2 and prognosis,and a nomogram was constructed.Gene enrichment analyses were performed for TRIB2.Correlations between TRIB2 expression and immune cell infiltration,immune checkpoints,tumor mutation burden(TMB),and immunotherapy sensitivity were analyzed.Results  TRIB2 was highly expressed in colon cancer tissues(P<0.05).The highest level of TRIB2 mRNA expression was found in CMS1.TRIB2 was an independent prognostic factor for colon cancer patients(univariate Cox regression analysis:HR=1.397,95%CI:1.100-1.774,P=0.006;multivariate Cox regression analysis:HR=1.502,95%CI:1.158-1.947,P=0.002).TRIB2 was closely associated with immune cell infiltration and positively correlated with the expression level of immune checkpoint molecules as well as TMB(r=0.39,P<0.001).The expression of TRIB2 was correlated with the efficacy of immune checkpoint inhibitors.Conclusions  TRIB2 is highly expressed in colon cancer and is closely associated with poor prognosis and the immune microenvironment of colon cancer patients.
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