论著

激素治疗对原发性肾病综合征患儿淋巴细胞亚群及免疫因子的影响

Effects of steroid therapy on lymphocyte subsets and immune factors in children with primary nephrotic syndrome

:1103-1108
 
       目的   分析原发性肾病综合征(PNS)患儿在糖皮质激素(激素)治疗后淋巴细胞亚群及免疫因子的水平变化,以探讨PNS耐药机制。方法   选取PNS患儿共71例,正常对照组108例,收集PNS患者在激素治疗前、后及正常对照组儿童的淋巴细胞亚群[CD4+ 、CD8+ 、CD4+ /CD8+ 、CD19+ 和自然杀伤(NK)细胞]及免疫因子水平,并分析激素治疗后激素敏感患儿和激素耐药患儿相关指标的差异。结果  PNS患儿淋巴细胞亚群及免疫因子水平异常,激素治疗后PNS患儿总免疫球蛋白E(IgE)水平[767.50(270.25,1 937.50)IU/mL vs 311.00(62.70,757.00)IU/mL](P=0.008)下降,而CD4+ T细胞比例[(33.88±7.42)% vs(38.25±7.16)%](P=0.004)升高,激素治疗敏感患儿NK细胞比例高于激素治疗耐药患儿[(8.39±4.60)% vs(4.72±1.99)%](P=0.034),IgE水平低于耐药患儿[311.00(62.70,633.00)IU/mL vs783.00(88.05,1 290.00)IU/mL](P<0.001)。结论  PNS患儿淋巴细胞亚群分布及免疫球蛋白水平异常,激素治疗可影响患儿CD4+ T细胞比例及IgE水平,并且NK细胞比例和IgE水平与患儿激素耐药相关。
       Objective  To evaluate the changes of lymphocyte subsets and immune factors levels in children with primary nephrotic syndrome(PNS),and explore the pathogenesis of PNS.Methods  A total of 71 patients with PNS and 108 normal control cases were selected.Flow cytometry was used to detect the concentration of lymphocyte subsets(CD4+ ,CD8+ ,CD4+ /CD8+ ,CD19+  and natural killer[NK] cells)and immune factors before and after treatment.The difference of  related factors between steroid-sensitive and steroid-resistant children after therapy were analyzed.Results  Lymphocyte subsets and immune molecule levels were abnormal in children with NPS.The level of IgE(767.50[270.25,1 937.50]IU/mL vs 311.00[62.70,757.00]IU/mL,P=0.008)was significantly decreased after therapy(P<0.05),while CD4+  T cells([33.88±7.42]% vs[38.25±7.16]%,P=0.004)were significantly increased.The level of NK cells in steroid-sensitive children was significantly higher than that in steroid-resistant children([8.39±4.60]% vs[4.72±1.99]%,P=0.034),while the level of  IgE was significantly lower than that of steroid -resistant children(311.00[62.70,633.00]IU/mL vs 783.00[88.05,1 290.00]IU/mL,P<0.001).Conclusions  The distribution of lymphocyte subsets and the level of immune factors in PNS children were abnormal.Steroid therapy could affect the levels of CD4+  T cells and IgE,and the levels of NK cells and IgE were related to steroid-resistance in PNS children.
论著

长病程 2 型糖尿病患者胰岛 β 细胞功能与 BMI 的相关性研究

Correlation between islet β cell function and BMI in patients with long course type 2 diabetes

:1094-1102
 
       目的   探讨长病程2型糖尿病(T2DM)患者体质指数(BMI)与胰岛β细胞功能间的相关关系。法    选取2023年12月—2024年3月于承德市中心医院内分泌风湿免疫科住院的260例长病程(病程≥10年)T2DM患者作为研究对象,依据BMI将其分成正常组、超重组和肥胖组,比较三组间一般资料、检验学指标及检查的差异,分析胰岛β细胞功能与各指标间的相关性。结果   三组研究对象在空腹静脉血糖(FPG)、空腹C肽(FCP)、胰岛素抵抗指数(HOMA-IR)、尿酸(UA)、甘油三酯(TG)等上差异有统计学意义(P<0.05),在胰岛β细胞功能指数(HOMA-β)比较差异无统计学意义(P>0.05);肥胖组的FPG、FCP、HOMA-IR、UA、TG均高于正常组(P<0.05),超重组的UA、TG均高于正常组(P<0.05),肥胖组的FPG、HOMA-IR、UA高于超重组(P<0.05),Spearman相关分析结果显示HOMA-β与体质量指数(BMI)无相关性(r=0.046,P=0.461),HOMA-β与UA(r=0.226,P<0.001)、TG(r=0.148,P=0.017)呈正相关,HOMA-IR与BMI(r=0.279,P<0.001)与、UA相关(r=0.284,P<0.001)及TG(r=0.349,P<0.001)呈正相关,多元线性回归分析显示UA是HOMA-β的影响因素(P<0.05),BMI、UA、TG是HOMA-IR的影响因素(P<0.05)。论    长病程的T2DM患者,其胰岛素抵抗水平随着BMI的增加逐渐升高,而胰岛β细胞功能指数与BMI的相关性不显著。同时,UA和TG也是长病程T2DM患者胰岛β细胞功能的影响因素。
       Objective  To explore the correlation between body mass index(BMI)and islet β cell function in patients with long course type 2 diabetes mellitus(T2DM).Methods  A total of 260 patients with T2DM with a long course of disease(course≥10 years)admitted to the Department of Endocrinology and Rheumatology of Chengde Central Hospital from December 2023 to March 2024 were selected as the study objects,and were divided into normal group,overweight group and obese group according to BMI.Comparison among the three groups in general data,inspection index and and the difference of the islet β cell function were performed,and the correlation among the indexes was analyzed.Results  There were statistically significant differences in fasting plasma glucose(FPG),fasting C peptide(FCP),homeostasis model assessment-insulin resistance(HOMA-IR),uric acid(UA)and triglycerides(TG)among the three groups(P<0.05),but no statistically significant differences in homeostatic model assessment of β-cell function(HOMA-β)(P>0.05).The levels of FPG,FCP,HOMA-IR,UA and TG in the obese group were higher than those in the normal group(P<0.05);the levels of UA and TG in the overweight group were higher than those inthe normal group(P<0.05);the levels of FPG,HOMA-IR and UA in the obese group were higher than those in the overweight groupP<0.05).Spearman correlation analysis showed that HOMA-β was not correlated with BMI(r=0.046,P=0.461),but was positively correlated with UA and TG(r=0.226,P<0.001;r=0.148,P=0.017),HOMA-IR was positively correlated with BMI,UA and TG(r=0.279,P<0.001;r=0.284,P<0.001;r=0.349,P<0.001).Multiple linear regression analysis showed that UA was the influencing factor of HOMA-β(P<0.05),BMI,UA and TG were the influencing factors of HOMA-IR(P<0.05).Conclusions  In T2DM patients with long disease course,the level of insulin  resistance increased gradually with the increase of BMI,but the correlation between β-cell function index and BMI was not significant.At the same time,UA and TG are also factors affecting the function of islet β cells in patients with long-course T2DM.
论著

免疫炎症通过激活 SOCS6/STAT6 通路调控前列腺细胞增殖

SOCS6/STAT6 pathway regulates inflammatory proliferation of prostatic cells

:1055-1060
 
       目的   研究SOCS6/STAT6通路在前列腺细胞炎性增殖作用中的调控作用。方法  使用人前列腺细胞株RWPE-1建立炎症模型,将细胞分为对照(CON)组和炎症刺激(INF)组,后者通过添加脂多糖(LPS)模拟炎症环境。采用ELISA检测白细胞介素-1β(IL-1β)-1β、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)表达水平,蛋白免疫印迹法检测细胞因子信号抑制物-6(SOCS6)、信号转导和转录激活因子-6(STAT6)及磷酸化STAT6蛋白的表达水平。结果  经过LPS处理后,RWPE-1细胞中的SOCS6蛋白表达水平显著下降(P<0.01),而磷酸化STAT6表达水平上升(P<0.01)。结论  SOCS6/STAT6通路可能通过调节炎症环境下STAT6的磷酸化水平,参与调节前列腺细胞的炎性增殖作用。

       Objective   To explore the  regulatory  role of  SOCS6/STAT6  pathway in the inflammatory  proliferation of 
prostate cells.Methods  The human prostate cell line RWPE-1 was used to establish an inflammation model.Cells were divided into a control(CON)group and an inflammation-stimulated(INF)group,with the latter subjected to lipopolysaccharide(LPS)treatment to simulate an inflammatory environment.The expression levels of interleukin(IL)-1β、IL-6 and  IL-8 were detected by ELISA,and the expression levels of suppressor of cytokine signaling 6(SOCS6),signal transducer and activator oftranscription-6,(STAT6),and phosphorylated STAT6 proteins were detected by Western blot.Results  The  results showed that after LPS treatment,the expression of SOCS6 protein in RWPE-1 cells significantly decreased,while the expression of phosphorylated STAT6 increased.Conclusions  The SOCS6/STAT6 pathway may be involved in  regulating the inflammatory proliferation of prostate cells by modulating the phosphorylation level of STAT6 under inflammatory conditions.
论著

免疫联合化疗对晚期 NSCLC 患者淋巴细胞免疫及生活质量的影响

Effect of immunotherapy combined with chemotherapy on lymphocyte immunity and quality of life in patients with advanced NSCLC

:760-765
 
       目的   探讨免疫治疗联合化学治疗(化疗)对晚期非小细胞肺癌(NSCLC)患者淋巴免疫及生活质量的影响,为临床进一步治疗提供参考。  选择2021年6月—2023年6月天津市滨海新区大港医院收治的晚期NSCLC患者120例进行研究,按抽签法分为干预组及对照组,每组60例,对照组采取单纯化疗方案,干预组采取免疫联合化疗方案,对比两组临床疗效、药物不良反应,治疗前后免疫功能(CD3+ 、CD4+ 、CD8+ )、糖类抗原199(CA199)、糖类抗原 125(CA125)、血清癌胚抗原(CEA)水平及健康状态调查表(QOL)评分。结果  干预组患者治疗总有效率高于对照组(68.33%>41.67%,P<0.05);治疗后干预组患者CD3+ 、CD4+ 比例高于治疗前及对照组治疗后,CD8+ 比例低于治疗前及对照组治疗后(P<0.05);治疗后干预组血清CA199、CA125、CEA水平均低于治疗前及对照组治疗后(P<0.05);干预组药物不良反应发生率为16.67%,对照组为36.67%,干预组低于对照组(P<0.05);治疗后干预组QOL各维度评分高于对照组及治疗前(P<0.05)。结论  与单纯化疗相比,免疫联合化疗治疗晚期NSCLC患者,能有效降低肿瘤标志物水平,改善患者免疫指标,减轻药物不良反应,提高患者疗效及生活质量。
       Objective  To explore the effect of immunotherapy combined with chemotherapy on lymphatic immunity and quality of life of patients with advanced non-small cell lung cancer(NSCLC),and to provide reference for further clinical treatment.Methods  A total of 120 patients with NSCLC from June 2021 to June 2023 were selected and divided into observation group and control group evenly according to the method of drawing lots,control group was treated with chemotherapy,the observation group was treated with immunotherapy combined with chemotherapy,and the clinical efficacy and adverse drug reactions were compared between the two groups.Before and after treatment,immune function(CD3+ ,CD4+ ,CD8+ ),carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125),serum carcinoembryonic antigen(CEA)levels and health status questionnaire(QOL-RRB- scores)were measured.Results The total effective  rate in the observation group was significantly higher than that in the control group(68.33%>41.67%,P<0.05).After treatment,the ratios of CD3+  and CD4+  in the observation group were significantly higher than those before treatment and control group after treatment,and the ratio of CD8+  was significantly lower than that before and after treatment in the control group(P<0.05).After treatment,the serum levels of CA199,CA125 and CEA in the observation group were lower than those before and after treatment in the control group(P<0.05).The incidence of adverse drug  reactions was 16.67% in the observation group and 36.67% in the control group,which was significantly lower in the observation group than in the control group(P<0.05).After treatment,the QOL scores in the observation group were significantly higher than those in the control group and before treatment(P<0.05).Conclusions  Compared with chemotherapy alone,immunotherapy combined with chemotherapy can effectively reduce the levels of tumor markers,improve the immune indexes of patients,reduce the adverse drug reactions,and improve the efficacy and quality of life of patients with advanced NSCLC.
论著

淋巴细胞亚群在鉴别低增生性骨髓增生异常综合征和再生障碍性贫血中的价值

The value of lymphocyte subpopulations in differentiation between hypoplastic myelodysplastic syndrome and aplastic anemia

:689-693
 
       目的   探讨淋巴细胞亚群在鉴别低增生性骨髓增生异常综合征(hypo-MDS)和再生障碍性贫血(AA)中的价值。方法   选取2020年7月—2023年6月在平顶山市第一人民医院治疗的80例hypo-MDS或和AA患者进行回顾性分析,其中hypo-MDS 48例、AA 32例,分析两组患者各类淋巴细胞(CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 、CD3+ CD57+ T-大颗粒淋巴细胞、CD3- CD16/CD56+ 自然杀伤细胞、CD19+ B淋巴细胞)的差异。结果   hypo-MDS组的CD3+ (78.42±8.02)%与AA组的(75.65±8.44)%对比差异无统计学意义(P>0.05);hypo-MDS组的CD4+ (47.54±6.88)%、CD4+ /CD8+(2.16±0.61)%高于AA组的CD4+ (40.11±5.71)%、CD4+ /CD8+ (1.49±0.48)%,CD8+ (23.12±6.42)%低于AA组CD8+ (31.77±6.79)%(P<0.05);hypo-MDS患者CD3+ CD57+ T-大颗粒淋巴细胞(13.45±3.77)%、CD3- CD16/CD56+自然杀伤细胞(12.32±3.97)%高于AA组CD3+ CD57+ T-大颗粒淋巴细胞(9.77±2.15)%、CD3- CD16/CD56+ 自然杀伤细胞(8.84±2.11)%,CD19+ B淋巴细胞(9.75±2.08)%低于AA组(12.65±3.35)%(P<0.05)。结论   淋巴亚群变化情况可用于AA和hypo-MDS的鉴别诊断。
       Objective  To explore the value of lymphocyte subsets in differentiation between hypoplastic myelodysplastic syndrome(hypo MDS)and aplastic anemia(AA).Methods  A  retrospective analysis was conducted on 80 patients with hypo MDS and AA who underwent treatment in the First People’s Hospital of Pingdingshan City from July 2020 to June 2023.Among them,there were 48 cases of hypo MDS and 32 cases of AA.The differences in lymphocytes(CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+CD3+ CD57+  T-large granular lymphocytes,CD3- CD16/CD56+  natural killer cells,and CD19+  B lymphocytes)between the two groups of patients were analyzed.Results  There was no statistically significant difference in CD3+ (78.42±8.02)% between the hypo MDS group and the AA group(75.65±8.44)%(P>0.05).The CD4+ (47.54±6.88)% and CD4+ /CD8+ (2.16±0.61)% in the hypo MDS group were higher than those in the AA group(40.11±5.71)% and (1.49±0.48)%,respectively.The CD8+(23.12±6.42)% was lower than that in the AA group(31.77±6.79)%(P<0.05).The levels of CD3+ CD57+  T-large granular lymphocytes(13.45±3.77)% and CD3- CD16/CD56+  natural killer cells(12.32±3.97)% in hypo MDS patients were higher than those in the AA group([9.77±2.15]%,[8.84±2.11]%),and CD19+  B lymphoid cells(9.75±2.08)% were lower than that in the AA group([12.65±3.35]%,P<0.05).Conclusions  The changes in lymphatic subpopulations can be used for the differential diagnosis of AA or hypo MDS
论著

CT、MRI 影像学表现对原发性肝细胞癌微血管侵犯的诊断价值

Diagnostic value of CT and MRI imaging manifestations for microvascular invasion in primary hepatocellular carcinoma

:681-688
 
       目的   探讨CT、MRI影像学表现对原发性肝细胞癌(HCC)微血管侵犯(MVI)的诊断价值。方法   选取2018年1月—2024年7月江门市第二人民医院(江门市中心医院蓬江分院)和江门市中心医院120例(共158个病灶)HCC患者,均行上腹部CT、MRI平扫+增强及弥散加权成像(DWI)检查;以术后病理结果为金标准。比较CT、MRI平扫+增强及DWI对HCC MVI诊断效能;分析HCC MVI诊断中CT、MRI平扫+增强及DWI检查与术后病理确诊结果之间的一致性;比较HCC MVI与无HCC MVI患者影像学表现及表观扩散系数(ADC)值。结果    DWI检查对HCC MVI的诊断效能(灵敏度、特异度、准确度、阳性预测值、阴性预测值)均显著性高于CT、MRI平扫+增强(P<0.05);CT、MRI、DWI对原发性肝细胞癌患者微血管侵犯的诊断效能比较,差异均无统计学意义(P>0.05)。在HCC MVI诊断效能中,CT、MRI影像学表现与术后病理确诊结果之间为中度一致性;DWI与术后病理确诊结果之间为高度一致性。HCC MVI患者的强化方式在非边缘动脉期强化、强化包膜、晕状强化、结中结、门脉分支癌栓占比均显著性高于无HCC MVI患者(P<0.05)。在不同b值(400、800、1 000、1 500 s/mm2 )下,HCC MVI患者的ADC值均显著性高于无HCC MVI患者(P<0.05)。结论    CT、MRI平扫+增强及DWI对HCC MVI均具有较好的诊断效能,而MRI诊断结果与病理诊断一致性更佳,尤其DWI图中ADC值可更加精准地判断HCC的患者是否发生微血管侵犯,有助于指导临床医生建立“个体化”精准诊疗策略。
       Objective  To explore the diagnostic value of CT and MRI imaging manifestations for microvascular invasion(MVI)in primary hepatocellular carcinoma(HCC).Methods  A total of 120 patients(158 lesions in total)with HCC in the Second People’s Hospital of Jiangmen(Pengjiang Branch of Jiangmen Central Hospital)and Jiangmen Central Hospital were selected from January 2018 to July 2024,all underwent CT and MRI plain + enhanced and diffusion-weighted imaging(DWI)of the upper abdomen;postoperative pathology results was used as the diagnostic gold standard.The diagnostic efficacy of CT,MRI plain + enhanced and DWI for HCC MVI was compared.The concordance among CT,MRI plain + enhanced and DWI examinations with postoperative pathological diagnostic findings in the diagnosis of HCC MVI.Imaging manifestations and apparent diffusion coefficient(ADC)values in patients with and without HCC MVI were compared.Results  Diagnostic effectiveness of DWI examination for HCC MVI(sensitivity,specificity,accuracy,positive predictive value,negative predictive value)were all significantly higher than those of CT and MRI plain + enhanced(P<0.05);none of the differences were statistically significant(P>0.05)in the comparison of diagnostic effectiveness of CT,MRI,and DWI for the diagnosis of MVI in patients with primary HCC.In HCC MVI diagnostic effectiveness,moderate concordance was found among CT,MRI imaging phenotypes and postoperative pathology results;high concordance was found between DWI and postoperative pathology results.In HCC MVI patients,the proportion of non-marginal arterial reinforcement,enhanced envelope,halo reinforcement,nodal in nodal and portal branch cancer thrombi was significantly higher than that in patients without HCC MVI(P<0.05).At different b-values(400,800,1 000,1 500 s/mm2 ),ADC values were all significantly higher in patients with HCC MVI than in patients without HCC MVI(P<0.05).Conclusions  CT,MRI plain + enhanced and DWI have good diagnostic effectiveness for HCC MVI,while MRI diagnostic results are in better concordance with pathologic diagnosis.In particular,ADC values in DWI maps can more accurately determine whether MVI occurs in patients with HCC,which helps to guide clinicians to establish“individualized”and precise diagnosis and treatment strategies.
论著

重楼皂苷Ⅰ通过 p53 信号通路诱导慢性粒细胞白血病细胞铁死亡

Ferroptosis of chronic myeloid leukemia cells induced by polyphyllin I through p53 signal pathway

:605-615
 
       目的  探讨重楼皂苷Ⅰ(PPI)对慢性髓系白血病细胞(K562)细胞的抑制作用及可能的作用机制。  采用CCK-8法筛选药物最适浓度,将培养时间为24 h的药物最适浓度作为后续实验的干预浓度。分组如下:(1)空白组;(2)PPI组;(3)抑制剂组;(4)PPI+抑制剂组。采用CCK-8法检测细胞增殖率;AO/EB染色观察细胞形态;流式细胞术检测凋亡率;ROS检测试剂盒检测活性氧(ROS)含量、还原型谷胱甘肽含量检测试剂盒检测谷胱甘肽(GSH)含量、细胞亚铁比色法测试盒检测细胞亚铁(Fe2+)含量;qRT-PCR法和蛋白免疫印迹法检测各组肿瘤蛋白53(p53)、钠氯离子依赖性氨基酸转运蛋白11(SLC7A11)、谷胱甘肽过氧化物酶4(GPX4)mRNA及蛋白表达量。结果  PPI抑制K562细胞的生长,且呈一定的剂量及时间依赖性(与同时间段的对照组0μmol/L比较,均P<0.01)。与空白组相比,PPI抑制K562细胞的增殖,提高了凋亡率,而铁死亡抑制剂(Ferrostian-1)的使用逆转了PPI对K562凋亡的促进作用(P<0.01)。与空白组相比,PPI组ROS、Fe2+含量升高,GSH含量下降,而铁死亡抑制剂的使用可下调ROS、Fe2+,上调GSH的含量(P<0.01)。PPI组较空白组p53 mRNA和蛋白表达水平升高,而SLC7A11、GPX4 mRNA和蛋白表达水平下降(P<0.05);PPI+抑制剂组细胞较重楼皂苷组p53 mRNA和蛋白表达水平下降,而SLC7A11、GPX4 mRNA和蛋白表达水平升高(P<0.05)。结论  PPI能够有效抑制K562细胞增殖,促进K562细胞铁死亡,其分子机制可能与p53信号通路的调控有关。
       Objective  To investigate the inhibitory effect of polyphyllin I(PPI)on chronic myeloid leukemia cells(K562)and its possible mechanism.Methods  K562 cell line was cultured in suitable environment,and the optimal concentration of the drug was screened by CCK-8 method.The optimal concentration of the drug cultured for 24 hours was used as the intervention concentration of the follow-up experiment.Cells were divided into the following groups:(1)blank group,(2)saponins group,(3)inhibitor group and(4)saponins + inhibitor group.The cell proliferation rate was detected by CCK-8 method.The cell morphology was observed by AO/EB staining.The apoptosis rate was detected by flow cytometry.The contents of  reactive oxygen species(ROS),glutathione(GSH)and ferrous(Fe2+)in different groups were detected,and the expression of mRNA and protein in different groups were detected by qRT- PCR and Western blot respectively.Results  PPI significantly inhibited the growth of K562 cells in a dose-and time-dependent manner.Compared with the blank group,PPI significantly inhibited the proliferation of K562 cells and increased the apoptosis rate of K562 cells,while the use of ferroptosis inhibitor(Ferrostian-1)reversed the promoting effect of PPI on apoptosis of K562 cells.Compared with the blank group,the contents of reactive oxygen species(ROS)and ferrous iron(Fe2+)increased and the content of glutathione(GSH)decreased in the saponins group.The use of Ferrostian-1 could down-regulate the contents of ROS and Fe2+ and increase the content of GSH in the cells treated with the drug.Compared with the blank group,the expression of p53 mRNA and protein in the saponins group increased,while the expression of SLC7A11,GPX4 mRNA and protein decreased.The expression of p53 mRNA and protein in the saponins + inhibitor group was lower than that in the saponins group,while the expression levels of SLC7A11,GPX4 mRNA and protein increased.Conclusions  PPI can effectively inhibit the proliferation of K562 cells and promote ferroptosis in K562 cells.The molecular mechanism can be related to the regulation of p53 signal pathway.
论著

CT 增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值

The application value of CT enhanced delayed scanning in preoperative diagnosis of non-small cell lung cancer

:547-552
 
       目的     探讨CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。方法    对2021年5月—2024年5月商丘市第一人民医院收治的82例非小细胞肺癌手术治疗患者进行回顾性分析,将其分为观察组,另选取82例肺部良性肿瘤患者作为对照组,收集其术前CT增强延迟扫描结果,以术后病理诊断结果为金标准,分析CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。并对比不同临床病理特征非小细胞肺癌患者CT增强延迟扫描的CT增强值,采用Spearman相关性分析法分析CT增强值与非小细胞肺癌病理特征的关系。结果  CT增强延迟扫描显示观察组患者分叶征(12.50% vs 53.57%)、内部空泡征数量(6.25% vs 39.29%)低于对照组(χ 2 =26.560、24.680,P<0.05),观察组患者边缘毛刺(56.25% vs 17.86%)、胸部凹陷征(59.38% vs 14.29%)、高于对照组(χ 2 =43.330、64.600,P<0.05);82例非小细胞肺癌通过CT增强延迟扫描共确诊79例,CT增强延迟扫描诊断对非小细胞肺癌的准确率为96.34%(79/82),与病理诊断结果100.00%对比差异无统计学意义(χ 2 =3.060,P=0.080);82例非小细胞肺癌平均CT增强值为(39.14±7.31),不同性别、年龄、肿瘤最大直径、淋巴结浸润情况患者CT增强值对比差异无统计学意义(P>0.05),不同病理类型[腺癌(43.75±7.15)vs 鳞癌(34.74±6.12)]、细胞分化程度[中、低分化(45.71±7.21)vs 高分化(32.81±5.11)]、临床分期[Ⅰ期(31.03±2.12)vs Ⅱ期(36.61±3.13)vs Ⅲa期(46.32±6.83)]患者、淋巴结转移[是(42.75±4.21)vs (35.77±8.13)]CT增强值对比差异有统计学意义(t/F=5.243、8.804、84.828、4.378,P<0.05);Spearman相关分析结果显示:病理类型、细胞分化程度、临床分期、淋巴结转移与非小细胞肺癌患者CT增强值呈正相关(r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008,P<0.05)。结论  CT增强延迟扫描技术对非小细胞肺癌术前确诊具有重要价值,其诊断准确率与病理诊断并无显著差异,且可通过CT增强延迟扫描技术确定患者CT增强值,从而为非小细胞肺癌患者术后病理特征判断提供参考。
      Objective  To explore the application value of CT enhanced  delayed  scanning in  preoperative  diagnosis of non-small cell lung cancer(NSCLC).Methods  A retrospective analysis was conducted on 82 patients with NSCLCwho underwent surgical treatment in a hospital from May 2021 to May 2024.They were included into  an  observation  group and another 82 patients with benign lung tumors were included in the control group.The  preoperative CT enhanced  delayed scanning results were collected,and the postoperative pathological diagnosis was used as the “gold standard” to analyze the application value of CT enhanced delayed scanning in the preoperative diagnosis of NSCLC.And the CT enhancement values of delayed CT scans in NSCLC patients with different clinical and pathological features were compared,and Spearman correlation analysis was used to analyze the relationship between CT enhancement values and pathological features of NSCLC.Results  CT enhanced delayed scanning showed that the number of lobular(12.50% vs 53.57%)and internal vacuolar signs(6.25% vs39.29%)in the observation group was significantly lower than that in the control group(χ 2 =26.560,24.680,P<0.05),while the edge spicules(56.25% vs 17.86%)and chest depression signs(59.38% vs 14.29%)in the observation group were significantly higher than that in the control group(χ 2 =43.330,64.600,P<0.05).A total of 79 cases of 82 NSCLC were diagnosed by CT-enhanced delayed scan,and the accuracy of CT-enhanced delayed scan diagnosis for NSCLC was 96.34%(79/82),with no significant difference from the pathological diagnosis result of 100.00%(χ 2 =3.060,P=0.080).The average CT enhancement value of 82 NSCLC cases was(39.14±7.31).There was no significant difference in CT enhancement values among patients of different genders,ages,maximum tumor diameter,and lymph node infiltration(P>0.05).Patients with different pathological types [adenocarcinoma(43.75±7.15)vs squamous cell carcinoma(34.74±6.12)],degree of cell differentiation [moderate,and low differentiation(45.7±7.21)vs high differentiation(32.81±5.11)],clinical stage [I(31.03±2.12)vs II(36.61±3.13)vs IIIa(46.32±6.83)] and lymph node metastasis [yes(42.75±4.21),vs no(35.77±8.13)] CT enhancement had significant difference(t/F=5.243,8.804,84.828,4.378,P<0.05).The Spearman correlation analysis results showed that pathological type,degree of cell differentiation,clinical stage,lymph node metastasis were positively correlated with CT enhancement values in NSCLC patients(r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008).Conclusions  CT enhanced delayed scanning has important value in preoperative diagnosis of NSCLC.Its diagnostic accuracy is not significantly different from pathological diagnosis,and the CT enhanced value of patients can be determined through CT enhanced delayed scanning,providing reference for postoperative pathological feature judgment of NSCLC patients.
综述

双硫死亡与其他细胞死亡在卵巢癌治疗中的研究进展

Research progress on disulfideptosis and other cell death pathways in ovarian cancer treatment

:452-456
 
       卵巢癌是导致女性死亡的全球第五大原因,其治疗效果受限于早期诊断和治疗方案的有限性。近年来,随着靶向治疗的不断发展,细胞死亡途径作为治疗靶点受到广泛关注,其中双硫死亡作为一种新发现的程序性细胞死亡形式,为癌症治疗提供了新的思路。文章探讨了双硫死亡及其他主要细胞死亡途径包括自噬、细胞焦亡、坏死性凋亡、铁死亡和铜死亡在卵巢癌治疗中的研究进展,有望为卵巢癌患者提供更有效的治疗选择。
    Ovarian cancer ranks as the fifth deadliest cancer among women worldwide,with treatment efficacy hampered 
by limited early diagnosis and therapeutic options.In recent years,with the continuous development of targeted therapies,cell death pathways have gained widespread attention as therapeutic targets.Among them,disulfideptosis,a newly discovered form of programmed cell death,offers a novel avenue for cancer treatment.This review aims to explore the research progress of disulfideptosis and other major cell death pathways including autophagy,apoptosis,necroptosis,ferroptosis,and cuproptosis in ovarian cancer therapy,with the potential to provide more effective treatment options for ovarian cancer patients.
专家述评

嗜酸性粒细胞在心血管疾病中的研究进展

Research progress of eosinophils in cardiovascular diseases

:429-438
 
      嗜酸性粒细胞(EOS)作为过敏反应中关键的先天免疫细胞,在心血管疾病的发生与发展进程中也扮演着至关重要的角色。大量证据显示,血液EOS计数与诸多心血管疾病之间存在紧密联系,但临床研究得出的结论不尽相同。基础研究发现,EOS一方面可通过释放白细胞介素-4(IL-4)、IL-13及阳离子蛋白等细胞因子,对心肌梗死、心肌肥厚、心力衰竭或腹主动脉瘤发挥保护作用;另一方面,EOS表达的阳离子蛋白和血小板活化因子会促进平滑肌细胞增殖和钙化,进而加速动脉粥样硬化的形成。因此,EOS在不同心血管疾病中所发挥的作用存在差异,这与疾病的演变进程、EOS的数量均密切相关。本文对现有的临床和基础研究成果进行汇总,阐述EOS在各类心血管疾病中的不同作用。
       Eosinophils(EOS),as key innate immune cells in allergic reactions,play a crucial role in the occurrence and development of cardiovascular diseases.Ample evidence shows that the count of blood EOS is closely related to many cardiovascular diseases.However,the conclusions drawn from clinical studies are inconsistent,and these contradictory observational  results still cannot be reasonably explained so far.Basic research has found that,on the one hand,EOS can exert protective effects on myocardial infarction,myocardial hypertrophy,heart failure,or abdominal aortic aneurysm by releasing cytokines such as interleukin-4(IL-4),IL-13,and cationic proteins;on the other hand,the cationic proteins and platelet activating factors expressed by EOS can promote the proliferation and calcification of smooth muscle cells,thereby accelerating the formation of atherosclerosis.Therefore,the roles played by EOS in different cardiovascular diseases vary,which is closely related to the evolution process of the disease and the number of EOS.This article will summarize the existing clinical and basic research results to elaborate the different roles of EOS in various cardiovascular diseases.
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