论著

miR-412抑制SOX6对黑色素瘤细胞的增殖及侵袭力影响的研究

Upregulation of miR-412 promotes melanoma proliferation and invasion by suppressing SOX6 expression

:611-617
 
目的 检测微小RNA(miR)在人黑色素瘤中的表达情况,研究miR-412通过抑制性别确定区Y框转录因子6(SOX6)的表达影响黑色素瘤细胞增殖及侵袭能力的变化。方法 癌症基因组图谱(TCGA)数据库分析发现miR-412在黑色素瘤中异常表达,为研究其表达与肿瘤的相关性,采用Transwell小室,非锚定独立生长实验分析miR-412对黑色素瘤细胞增殖及侵袭能力的影响。软件预测SOX6可能为其靶向基因,采用荧光素酶报告分析及Western blot实验检测SOX6与miR-412的靶向调节情况。结果 TCGA数据库分析黑色素瘤组织中miR-412表达水平高于正常对照组,表达越高,生存时间越短。Transwell小室,非锚定独立生长实验显示miR-412过表达后促进细胞增殖及侵袭能力,而下调miR-412后抑制黑色素瘤细胞增殖及侵袭能力;通过靶点预测miR-412结合SOX6基因3’-非翻译区(UTR),导致SOX6蛋白因miR-412表达增高而下调;同时在miR-412下调的细胞中抑制SOX6表达可恢复黑色素瘤细胞的增殖及侵袭能力。结论 miR-412过表达后促进黑色素瘤细胞增殖及侵袭能力,反之则抑制黑色素瘤细胞增殖及侵袭能力。 miR-412通过靶向调控SOX6影响黑色素瘤细胞增殖及侵袭,提示miR-412在黑色素瘤的发病过程中起重要作用,是潜在的治疗靶点。
Objective To assess the expression of miR-412 in human melanoma and investigate how miR-412 modulates melanoma cell proliferation and invasive capacity by inhibiting SRY-Box Transcription Factor 6,(SOX6) expression.Methods Analysis of the TCGA(The Cancer Genome Atlas)database identified aberrant miR-412 expression in melanoma.To explore its relevance to tumorigenesis,we conducted Transwell chamber and non-adherent independent growth assays to examine the effects of miR-412 on melanoma cell proliferation and invasion.Software predictions highlighted SOX6 as a potential target gene.We performed luciferase reporter assays and Western blot experiments to elucidate the regulatory interactions between SOX6 and miR-412.Results TCGA database analysis revealed significantly elevated miR-412 expression levels in melanoma tissues compared to the normal control group.Moreover,higher miR-412 expression correlated with shorter survival times.Functional assays using Transwell chambers and non-adherent independent growth assays demonstrated that overexpressing miR-412 enhanced cell proliferation and invasive capabilities.Conversely,reducing miR-412 expression restrained these attributes in melanoma cells. Target prediction analysis indicated that miR-412 binds to the 3’-UTR region of SOX6,resulting in decreased SOX6 protein levels due to increased miR-412 expression.Intriguingly,inhibiting SOX6 expression concurrently amplified the proliferation and invasive potential of melanoma cells,which was initially dampened by miR-412 downregulation.Conclusions Elevated miR-412 expression augments melanoma cell proliferation and invasive capabilities,while its suppression diminishes these traits.Through its targeted regulation of SOX6,miR-412 exerts a significant influence on melanoma cell proliferation and invasion.These findings underscore the pivotal role of miR-412 in melanoma pathogenesis and underscore its potential as a promising therapeutic target.
专家述评

干细胞疗法及神经调控技术在脊髓损伤中的研究进展

Research progress on application of stem cell and neuromodulation technology in spinal cord injury

:689-704
 
脊髓损伤是一种高致残性中枢神经系统疾病,目前缺乏有效的治疗措施。干细胞组织工程兴起和神经调控技术的发展,给脊髓损伤的治疗带来新的希望。目前,多项针对脊髓损伤的干细胞相关治疗项目的临床研究已在全球注册,干细胞疗法是脊髓损伤领域的研究热点,具有良好的应用前景。而神经调控技术一直在临床上脊髓损伤后的康复治疗中发挥着重要作用,特别是靶向神经调控技术近年在脊髓损伤治疗方面取得突破性进展。有研究尝试联合干细胞疗法和神经调控技术应用治疗脊髓损伤,试图取得更好的效果。本文综述了干细胞疗法和神经调控技术在脊髓损伤治疗中的研究进展,旨在探讨其作用效果、修复机制、应用前景以及面临的问题,进一步为脊髓损伤的基础研究和临床转化提供参考。
Spinal cord injury is a highly disabling disease of the central nervous system without effective treatment to date.With the rise of stem cell and tissue engineering,and the breakthrough of neuromodulation technology,it brings new hope to the treatment of spinal cord injury.At present,a number of clinical studies on stem cell-related treatment projects for spinal cord injury have been registered worldwide,which has become a research hotspot.Neuromodulation technology has been playing an important role in the clinical rehabilitation of spinal cord injury.Especially,breakthroughs have been made in the treatment of spinal cord injury by targeted neuromodulation technology in recent years,which is encouraging.Some studies have attempted to combine stem cell therapy and neuromodulation technology to treat spinal cord injuries in an attempt to achieve better effect.This review summarizes the research progress of stem cell therapy and neuromodulation technology in the treatment of spinal cord injury,with the aim of discussing their effect,repair mechanisms,application prospect and various problems to face,and providing further reference for the basic research and clinical transformation of spinal cord injury.
论著

儿童嗜酸细胞性胃肠炎的临床诊治分析

Clinical diagnosis and treatment of eosinophilic gastroenteritis in children

:1027-1032
 
目的 总结儿童嗜酸细胞性胃肠炎(EG)的临床表现、内镜检查和病理学特点、治疗和预后。方法 回顾性分析2019年1月—2022年12月滨州医学院附属医院儿科确诊的48例EG患儿临床资料,包括临床症状、实验室检查、影像学检查、内镜和病理学检查、治疗和随访情况。结果 48例患儿中,男26例(54.17%),女22例(45.83%),中位年龄7.8岁,20例(41.67%)患儿有过敏史或家族史,临床症状主要有腹痛(34例,70.83%)、腹泻(18例,37.5%)和腹胀(12例,25%)。外周血嗜酸性粒细胞(EOS)升高36例(75%),血清总IgE升高14例(29.17%)。48例行胃镜检查,最常见的表现是黏膜充血水肿(32例,66.67%)、点状红斑(28例,58.33%)和糜烂(22例,45.83%),28例行结肠镜检查,表现为黏膜充血水肿(18例,64.29%)、点状红斑(15例,53.57%)和结节样隆起(12例,42.86%)。黏膜组织病理表现为大量EOS浸润,主要累及十二指肠降部、胃窦和回肠末端。所有患儿均采用饮食干预的治疗,6例(12.5%)单纯饮食干预治疗后好转,16例(33.33%)孟鲁司特钠、酮替芬、奥美拉唑治疗后好转,26例(54.17%)联合泼尼松治疗后好转,随访10个月~3年,8例(16.67%)停药后复发,再次治疗后好转。结论 儿童EG临床症状和内镜表现多样化、缺乏特异性,内镜下黏膜组织病理检查有助于确诊。大多数患儿外周血EOS升高,饮食干预和糖皮质激素治疗效果显著,但存在复发的可能,需长期维持治疗和随访。
Objective To summarize the clinical manifestations,endoscopic and pathological features,treatment and prognosis of eosinophilic gastroenteritis(EG)in children.Methods A retrospective analysis was carried out on clinical data of 48 patients with EG diagnosed at the Department of Pediatrics of Binzhou Medical University Hospital from January 2019 to December 2022,including clinical symptoms,laboratory examination,imaging examination,endoscopic and pathological examination,treatment and follow-up.Results A total of 48 patients were included in the analysis,including 26 males(54.17%)and 22 females(45.83%),with the median age of 7.8 years(7 months to 13 years).Twenty patients(41.67%)had a history or family history of allergy.The most clinical symptoms were abdominal pain(34 cases,70.83%),diarrhea(18 cases,37.5%)and abdominal distension(12 cases,25%).Peripheral blood eosinophils(EOS)increased in 36 cases(75%),and the serum total IgE increased in 14 cases(29.17%).48 cases underwent gastroscopy,the most common manifestations were mucosal hyperemia and edema(32 cases,66.67%),punctate erythema(28 cases,58.33%)and erosion(22 cases,45.83%).Twenty-eight cases underwent colonoscopy,the manifestations were mucosal hyperemia and edema(18 cases,64.29%),spotted erythema(15 cases,53.57%)and nodular eminence(12 cases,42.86%).Mucosal histopathology showed a large number of EOS infiltration,mainly involving the descending duodenum,gastric antrum and terminal ileum.All children were treated with dietary intervention,6 cases(12.5%)were improved after simple diet intervention,16 cases(33.33%)were improved after treatment with montelukast,ketotifen,omeprazole,26 cases(54.17%)were improved after combined treatment with prednisone acetate.Followed up for 10 months to 3 years,8 cases(16.67%)relapsed after drug withdrawal and improved after retreatment.Conclusions The clinical symptoms and endoscopic manifestations of EG in children are diverse and lack of specificity,endoscopic mucosal histopathological examination is helpful for diagnosis.The EOS in peripheral blood of most children increased,diet intervention and glucocorticoid therapy are effective,but there is a possibility of recurrence,which need long-term maintenance treatment and follow-up.
论著

microRNA-29b对子宫内膜癌细胞增殖、迁移和侵袭的影响

Effect of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells

:1002-1008
 
目的 探讨微RNA-29b(miR-29b)对子宫内膜癌细胞增殖、迁移和侵袭的影响。方法 子宫内膜癌HEC-1-B细胞分为miR-29b模拟物组(MM组)、miR-29b阻遏物组(MR组)和阴性对照物组(MNC组),分别转染miR-29b拟似物、miR-29b阻遏物和miR-29b阴性对照物,每组设置6个复孔。以实时定量逆转录PCR检测miR-29b表达,以水溶性四氮唑(WST-1)检测miR-29b对HEC-1-B子宫内膜癌细胞增殖的影响,以Transwell小室检测HEC-1-B子宫内膜癌细胞迁移和侵袭的影响,以Western blot法检测磷酸酶张力蛋白同源物(PTEN)-蛋白激酶 B(AKT)通路蛋白表达水平。结果 MNC组、MM组、MR组miR-29b相对表达量分别为(2 032.1±873.4)、(19 272.8±2 087.9)、(472.7±105.6),组间比较差异有统计学意义(P<0.05)。MM组0、3、5、7 d时OD值分别为(0.32±0.06)、(0.53±0.08)、(1.13±0.12)和(1.92±0.14),MNC组0、3、5、7 d时OD值分别为(0.34±0.09)、(0.71±0.08)、(1.67±0.21)和(3.49±0.24),MR组0、3、5、7 d时OD值分别为(0.38±0.09)、(0.84±0.18)、(2.43±0.24)和(5.67±0.15),3组0 d时OD值比较差异无统计学意义(P=0.216),三组3 d、5 d、7 d时OD值比较差异存在统计学意义(P<0.001)。MNC组、MM组和MR组迁移细胞数分别为(403.9±23.8)(102.6±15.7)和(685.7±46.8)个,上述3组侵袭细胞数分别为(82.1±12.7)(38.2±10.6)和(124.6±21.6)个,MM组和MNC组上述指标比较差异均有统计学意义(P<0.05),MR组和MM组上述指标比较差异均有统计学意义(P<0.05)。MNC组、MM组、MR组PTEN蛋白相对表达量分别为(0.25±0.08)、(0.69±0.11)、(0.11±0.05),上述3组p-AKT蛋白相对表达量分别为(0.58±0.10)、(0.13±0.06)和(0.79±0.08),上述3组AKT蛋白相对表达量分别为(0.38±0.09)、(0.37±0.11)和(0.37±0.08),MM组与MNC组PTEN、p-AKT水平比较差异有统计学意义(P<0.05),AKT水平比较差异无统计学意义(P>0.05);MR组与MNC组、MM组PTEN、p-AKT水平比较差异有统计学意义(P<0.05),AKT水平比较差异无统计学意义(P>0.05)。结论 过表达miR-29b对子宫内膜癌细胞增殖、迁移和侵袭具有抑制作用,靶向PTEN-AKT可能是其重要作用途径。
Objective To investigate the effects of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells.Methods The endometrial cancer HEC-1-B cells were divided into micro29b mimetic group(MM group),micro29b repressor group(MR group)and negative control group(MNC group),and the micro29b mimetic,micro29b repressor and micro29b negative control were transfected into each group,six compound holes with each group.The real-time quantitative reverse transcription polymerase chain reaction(RT-PCR)was used to detect the expression of mi29b,WST-1 was used to detect the effect of mi29b on the proliferation of HEC-1-B endometrial cancer cells,Transwell chamber was used to detect the migration and invasion of HEC-1-B endometrial cancer cells,and Western blot was used to detect the expression level of PTEN-AKT pathway protein.Results The relative expression levels of microRNA-29b in MNC group,MM group and MR group were(2 032.1±873.4),(19 272.8±2 087.9)and(472.7±105.6),respectively,and there were significant differences between groups(P<0.05).OD values of MM group at 0 d,3 d,5 d and 7 d were(0.32±0.06),(0.53±0.08),(1.13±0.12)and(1.92±0.14)respectively.The OD values of MNC group at 0,3,5 and 7 days were(0.34±0.09),(0.71±0.08),(1.67±0.21)and(3.49±0.24)respectively.The OD values of MR group at 0 d,3 d,5 d and 7 d were(0.38±0.09),(0.84±0.18),(2.43±0.24)and(5.67±0.15)respectively.There was no significant difference in OD value between the three groups on day 0 (P=0.216).There were significant differences in OD value between the three groups on day 3,day 5 and day 7(P<0.001).The number of migrating cells in MNC group,MM group and MR group were(403.9±23.8)cells,(102.6±15.7)cells and(685.7±46.8)cells,respectively.The number of invasive cells in the above three groups were(82.1±12.7)cells,(38.2±10.6)cells and(124.6±21.6)cells.There were significant differences in the above indexes between MM group and MNC group(P<0.05),also between MR group and MM group(P<0.05).The relative expression levels of PTEN protein in MNC group,MM group and MR group were(0.25±0.08),(0.69±0.11)and(0.11±0.05).The relative expression levels of p-AKT protein in the above three groups were(0.58±0.10),(0.13±0.06)and(0.79±0.08).The relative expression levels of AKT protein in the above three groups were(0.38±0.09),(0.37±0.11)and(0.37±0.08),respectively.Compared with MNC group,the levels of PTEN and p-AKT in MM group had statistical significance(P<0.05),but there was no statistical difference in AKT level(P>0.05).Compared with MNC group and MM group,the levels of PTEN and p-AKT in MR group had statistical significance(P<0.05),and there was no statistical difference in AKT level(P>0.05).Conclusions Overexpression of microRNA-29b can inhibit the proliferation,migration and invasion of endometrial cancer cells,and targeting PTEN-AKT may be an important pathway.
专家述评

弥漫性大B细胞淋巴瘤的放射治疗进展

Recent progress in radiation therapy for diffuse large B-cell lymphoma

:974-984
 
弥漫性大B细胞淋巴瘤(DLBCL)是最常见的高度异质性非霍奇金淋巴瘤(NHL),不同的疾病阶段或临床亚型预后不尽相同。放射治疗作为无交叉耐药的理想局部治疗技术,应用于DLBCL可有效改善患者预后。初治DLBCL通过放射治疗联合化学治疗、免疫治疗等综合治疗可使约60%~70%患者疾病缓解。对于不同预后影响因素,如年龄、肿瘤体积、淋巴结外侵犯等,联合放射治疗也可取得更佳疗效。在复发性/难治性DLBCL的治疗中,自体造血干细胞移植(ASCT)和嵌合抗原受体T细胞免疫治疗(CAR-T)是目前的研究热点,而放射治疗无论是作为ASCT与CAR-T术前的桥接治疗或失败后的挽救性治疗均有助改善患者预后。随着放射治疗技术的日益优化,放射治疗在综合治疗方案中扮演着越来越重要的角色。
Diffuse large B-cell lymphoma(DLBCL)is a highly heterogeneous type of non-Hodgkin lymphoma(NHL)and its prognosis is different for different disease stages or clinical subtypes.Radiation therapy(RT)is a local treatment technique that does not cause cross-resistance and can effectively improve the prognosis of patients with DLBCL.When combined with chemotherapy and immunotherapy,RT can alleviate the disease in more than 60% of patients.Furthermore,RT can achieve better results for different prognostic factors such as age,tumor volume and external nodal invasion.For treating relapsed / refractory DLBCL,autologous stem cell transplantation(ASCT)and chimeric antigen receptor T cell immunotherapy(CAR-T)are currently being researched,while RT can help as bridging therapy before ASCT and CAR-T or salvage therapy after failure.With the increasing optimization of technology,radiotherapy plays an increasingly important role in combined treatment options.
论著

应变超声心动图早期检测蒽环类药物诱导的急性淋巴细胞白血病患儿左心室功能障碍

Strain echocardiography detecting left ventricular dysfunction in children with acute lymphocytic leukemia induced by anthracycloids

:1308-1313
 
目的 探讨常规超声心动图联合二维斑点追踪技术评估急性白血病患儿在接受蒽环类药物治疗后产生的心脏毒性,早期检测左心功能障碍。方法 采用前瞻性非随机观察研究,选取新诊断急性淋巴细胞白血病患儿20例,分别于确诊白血病后接受蒽环类药物治疗前、接受所有蒽环类药物剂量后以及确诊白血病1年后,进行常规超声心动图和二维斑点技术监测评估心脏毒性。结果 左室流出道速度积分TVI和E、E/E’在治疗期间下降,并在诊断后1年恢复至治疗前数值。在二维斑点追踪纵向应变中,GLPS-LAX、GLPS-A2C、LV-GLPS在完成所有蒽环类药物剂量后与诊断后比较差异有统计学意义,以及诊断后1年与蒽环类药物治疗后比较差异有统计学意义。但GLPS-A4C各时间点比较差异无统计学意义。结论 常规超声心动图联合二维斑点追踪技术的纵向整体应变可早期发现白血病患儿化疗所致的左室功能障碍。
Objective To evaluate cardiotoxicity in children with acute lymphoblastic leukemia treated with anthracyclines by echocardiography combined with 2D speckle tracking imaging,and to detect left heart dysfunction early.Methods In this prospective nonrandomized study,20 children with newly diagnosed acute lymphoblastic leukemia were assessed for cardiotoxicity by echocardiography and 2D speckle tracking imaging in three periods during the treatment.Results The left ventricular outflow tract velocity integral TVI and E,E/E’ decreased during treatment,and went back to the pre-treatment value one year after diagnosis.In the longitudinal strain of 2D speckle tracking imaging,in GLPS-LAX,GLPS-A2C,LV-GLPS,there were statistical differences between treatment completed and after diagnosis,and between 1 year after diagnosis and treatment completed.However,GLPS-A4C has no statistical significance.Conclusion sThe conventional echocardiography combined with longitudinal overall strain of 2D speckle tracking imaging can comprehensively evaluate the early changes of left ventricular dysfunction caused by chemotherapy in children with leukemia.
论著

联合PD-1/L1免疫检查点抑制剂方案用于EGFR-TKIs耐药后晚期非小细胞肺癌的疗效分析

Efficacy analysis of the combined PD-1/L1 immune checkpoint inhibitor regimen for advanced non-small cell lung cancer after EGFR TKIs resistance

:1437-1443
 
目的 探讨表皮生长因子受体酪氨酸酶抑制剂(EGFR-TKIs)一线治疗耐药后,二线化学治疗(化疗)联合程序性死亡蛋白1及其配体(PD-1/L1)免疫检查点抑制剂方案对晚期非小细胞肺癌(NSCLC)的疗效。方法 选取2018年 6月—2022年10月期间就诊于南通大学附属肿瘤医院院的80例有完整临床资料、应用EGFR-TKIs耐药后晚期NSCLC患者进行回顾性分析,依照不同治疗方式将患者分为观察组与对照组,均为40例。对照组一线EGFR-TKIs治疗耐药后进行二线化疗,观察组一线EGFR-TKIs治疗耐药后进行二线化疗联合PD-1/L1免疫检查点抑制剂治疗。对比两组临床疗效及无进展生存期(PFS),化疗前后血清中人细胞角蛋白21-1片段(Cyfra21-1)、糖类抗原125(CA125)、碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)水平变化,不良反应发生率及生存质量。结果 观察组客观缓解率与疾病控制率高于对照组(P<0.05),对照组PFS为10(2.38,24.13)个月,观察组PFS为14(5.27~,5.27)个月,观察组高于对照组(χ2=4.536,P=0.041);化疗后两组bFGF、VEGF,CA125、Cyfra21-1肿瘤标志物水平均比化疗前降低,且观察组[(17.85±3.32)ng/L、(310.51±88.37)ng/L、(51.62±13.66)U/mL、(10.26±3.37)ng/mL]低于对照组[(19.62±3.24)ng/L、(366.26±49.42)ng/L、(59.26±9.35)U/mL、(12.62±2.73)ng/mL],对比差异有统计学意义(t1=2.413,P1=0.018;t2=3.482,P2<0.001;t3=2.919,P3=0.005;t4=3.442,P4<0.001);两组不良反应发生率对比差异无统计学意义(P>0.05);化疗后两组世界卫生组织生存质量量表简表评分均升高,观察组[(98.62±8.24)、(101.53±12.62)、(95.28±11.15)、(97.79±10.47)分]高于对照组[(84.25±7.32)、(93.58±15.75)、(82.24±9.34)、(83.47±8.38)]分,对比差异有统计学意义(t1=8.246,P1<0.001;t2=2.491,P2=0.015;t3=5.670,P3<0.001;t4=6.753,P4<0.001)。结论 对EGFR-TKIs耐药后晚期非小细胞肺癌患者采取二线化疗联合PD-1/L1免疫检查点抑制剂可提升其临床疗效及生存期,改善血清相关肿瘤标志物表达水平,提升患者生存质量。
Objective To explore the therapeutic effect of second-line chemotherapy combined with PD-1/L1 immune checkpoint inhibitor regimen on advanced non-small cell lung cancer(NSCLC) after epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)resistance in first-line chemotherapy.Methods Retrospectively selected 80 patients with advanced NSCLC EGFR TKIs resistance,who were admitted to the Affiliated Cancer Hospital of Nantong University from June 2018 to October 2022.Patients were divided into an observation group and a control group according to different treatment methods,with 40 cases in each group.The control group received second-line chemotherapy after first-line EGFR-TKIs therapy resistance,while the observation group received second-line chemotherapy and PD-1/L1 inhibitor after first-line EGFR-TKIs therapy reactions and quality of live.Clinical efficacy and PFS,changes in serum levels of human Cyfra21-1,CA125,bFGF,VEGF,incidence of adverse chemotherapy of two groups were compared.Results The ORR and DCR of the observation group were significantly higher than those of the control group(P<0.05).The mean PFS of the control group was 10(2.38-24.13)months,while the mean PFS of the observation group was 14(5.27-35.27)months.The observation group was higher than the control group(χ2=4.536,P=0.041).After chemotherapy,levels of bFGF,VEGF,CA125 and Cyfra21-1 tumor markers decreased in both groups,and the observation group [(17.85±3.32)ng/L,(310.51±88.37)ng/L,(51.62±13.66)U/mL,(10.26±3.37)ng/mL] was lower than the control group [(19.62±3.24)ng/L,(366.26±49.42)ng/L,(59.26±9.35)U/mL,(12.62±2.73)ng/mL],which showed statistically significant difference in the comparison(t1=2.413,P1=0.018;t2=3.482,P2<0.001;t3=2.919,P3=0.005;t4=3.442,P4<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the WHO QOL-BREF scores increased in both patient groups and the observation group scores[(98.62±8.24),(101.53±12.62),(95.28±11.15),(97.79±10.47)] were higher than the control group scores[(84.25±7.32),(93.58±15.75),(82.24±9.34),(83.47±8.38)],which showed statistically significant difference.(t1=8.246,P1<0.001;t2=2.491,P2=0.015;t3=5.670,P3<0.001;t4=6.753,P4<0.001).Conclusions The combination of second-line chemotherapy with PD-1/L1 immune checkpoint inhibitors can improve the clinical efficacy and survival of advanced NSCLC patients who are resistant to EGFR-TKIs,improve the expression levels of serum related tumor markers,and enhance the quality of life of patients.
论著

YAP、p65与弥漫大B细胞淋巴瘤临床特征的相关性及临床意义

Correlation and clinical significance of YAP and p65 with clinical features of diffuse large B-cell lymphoma

:1389-1396
 
目的 探讨Yes1相关蛋白(YAP)及p65在弥漫大B细胞淋巴瘤(DLBCL)中与临床特征的相关性及对DLBCL治疗和预后的意义。方法 收集65例DLBCL和10例反应性增生淋巴结患者组织进行免疫组织化学染色,分析两组差异;对多种临床特征与YAP、p65的相关性进行统计学和生存差异性分析。结果 YAP、p65染色评分在两组间比较差异有统计学意义(P<0.05);YAP评分与疗效分组呈正相关,与治疗前乳酸脱氢酶(LDH)、Ann-Arbor分期、国际预后指数(IPI)呈负相关(P<0.05);p65表达与疗效分组呈负相关,与治疗前LDH水平、Ann-Arbor分组、美国东部肿瘤协作组活动状态评分(ECOG)ECOG分组、结外侵犯、IPI评分、巨大包块呈正相关(P<0.05)。IPI及p65评分是DLBCL患者总生存期(OS)的独立危险因素(P<0.05)。共表达分层中YAP-/p65+组患者OS均值最低。结论 对于DLBCL,YAP低表达或p65高表达提示患者瘤荷较大、较差的疗效和预后。
Objective To investigate the correlation of YAP and p65 with clinical features in diffuse large B-cell lymphoma(DLBCL)and the significance for treatment and prognosis.Methods Tissues from 65 patients with DLBCL and 10 patients with reactive hyperplasia lymph node were collected for immunohistochemistry staining to analyze the differences between the two groups;statistical analysis and survival difference analysis of the correlation between various clinical features and YAP,p65 were performed.Results YAP and p65 staining scores were significantly different between the two groups(P<0.05).YAP scores were positively correlated with efficacy subgroups,and negatively correlated with LDH levels before treatment,Ann-Arbor staging,and International Prognostic Index(IPI)scores before treatment(P<0.05);p65 expression was negatively correlated with efficacy subgroups,and positively correlated with pretreatment LDH levels,Ann-Arbor subgroup,ECOG subgroup,extra-nodal invasion,IPI scores,and huge mass(P<0.05).IPI and p65 score were independent prognostic risk factors for overall survival(OS) in DLBCL patients(P<0.05).The mean value of OS was the lowest in patients in the YAP-/p65+ group in the co-expression stratification.Conclusions Low expression of YAP or high expression of p65 suggests larger tumor load and poorer outcome and prognosis in patients for DLBCL.
论著

S-ChE联合T细胞表面PD-1水平对脓毒症患者病情预后状况评估的价值

The effect of S-ChE combined with T cell surface PD-1 level on the evaluation of the prognosis of patients with sepsis

:83-87
 
目的 观察脓毒症患者血清胆碱酯酶(S-ChE)和T细胞程序性死亡分子-1(PD-1)以及炎症因子水平,并分析其与患者预后关系。方法 选取2018年8月—2021年5月在我院接受治疗的脓毒症患者为研究对象,同时选取同期在我院接受体检的健康人群为对照组。根据脓毒症患者的预后分为存活组和死亡组。比较脓毒症组和对照组、脓毒症存活组和死亡组患者S-ChE、PD-1水平和炎症因子水平的差异,并分析与患者预后的关系。结果 脓毒症患者的S-ChE水平低于对照组,PD-1水平高于对照组(P<0.05)。脓毒症患者的CRP、PCT水平高于对照组,CD3+T、CD3+CD4+T和CD4+CD8+T水平低于对照组(P<0.05)。死亡组患者的S-ChE水平低于存活组,PD-1水平高于存活组(P<0.05)。死亡组患者的CRP、PCT水平高于存活组,CD3+T、CD3+CD4+T和CD4+CD8+T水平低于存活组(P<0.05)。脓毒症患者S-ChE、PD-1水平呈负相关,(P<0.05)。脓毒症患者的S-ChE与 CRP、PCT水平负相关,与CD3+T、CD3+CD4+T、CD4+CD8+T水平正相关(P<0.05)。脓毒症患者的PD-1与 CRP、PCT水平正相关,与CD3+T、CD3+CD4+T、CD4+CD8+T水平负相关(P<0.05)。S-ChE、PD-1预测脓毒症患者预后的AUC值为0.725(95%CI:0.605~0.825)、0.706(95%CI:0.585~0.809),P<0.05。结论 脓毒症患者的S-ChE水平较低,PD-1水平较高,且与炎症因子水平和患者的预后相关。
Objective To analyze the levels of serum cholinesterase (S-ChE), programmed death 1 (PD-1) and inflammatory factors in patients with sepsis, and analyze the relationship between them and the prognosis of patients. Methods Patients with sepsis treated in our hospital from August 2018 to May 2021 were selected as the research subjects, and healthy people who received physical examinations in our hospital during the same period were selected as the control subjects.The differences in the levels of S-ChE, PD-1 and inflammatory factors between the sepsis group and the control group, the sepsis survival group and the death group were compared, and their relationship with the prognosis of the patients were analyzed. Results The level of S-ChE in patients with sepsis was lower than that of the control group, and the level of PD-1 was higher than that of the control group (P<0.05).The CRP and PCT levels of sepsis patients were higher than those of the control subjects, and the levels of CD3+T, CD3+CD4+T and CD4+CD8+T were lower (P<0.05).The S-ChE level of the death group was lower than that of the survival group, and the PD-1 level was higher than that of the survival group (P<0.05).The levels of CRP and PCT in the death group were higher than those in the survival group, and the levels of CD3+T, CD3+CD4+T and CD4+CD8+T were lower than those in the survival group (P<0.05).The levels of S-ChE and PD-1 in sepsis patients were negatively correlated (P< 0.05).S-ChE level in patients with sepsis was negatively correlated with CRP and PCT levels, and positively correlated with CD3+T, CD3+CD4+T, and CD4+CD8+T levels (P<0.05).PD-1 level in patients with sepsis was positively correlated with CRP and PCT levels, and negatively correlated with CD3+T, CD3+CD4+T, and CD4+CD8+T levels (P<0.05).The AUC values of S-ChE and PD-1 predicting the prognosis of patients with sepsis were 0.725 (95% CI: 0.605~0.825), 0.706 (95% CI: 0.585~0.809), P<0.05. Conclusions Patients with sepsis had lower level of S-ChE and higher level of PD-1, which were related to the levels of inflammatory factors and the prognosis of patients.
论著

非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素

Occurrence of bone marrow suppression and its influencing factors in patients with non-small cell lung cancer undergoing chemotherapy

:61-63
 
目的 分析非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素。方法 回顾性分析2017年2月—2019年8月期间本院进行化疗治疗的80例非小细胞肺癌患者临床资料,统计非小细胞肺癌化疗患者骨髓抑制发生情况,并根据其情况分组;收集所有患者临床资料,分析非小细胞肺癌化疗患者骨髓抑制发生的相关影响因素。结果 80例非小细胞肺癌化疗患者中发生骨髓抑制45例,发生率为56.25%;经单因素及多项Logistic回归分析,年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移是非小细胞肺癌化疗患者发生骨髓抑制的影响因素(OR>1,P<0.05)。结论 年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移会增加非小细胞肺癌化疗患者骨髓抑制的发生风险,临床上可据此来制定合理的干预措施,以降低患者骨髓抑制的发生风险。
Objective To analyze the occurrence and influencing factors of bone marrow suppression in patients with non-small cell lung cancer (NSCLC) undergoing chemotherapy. Methods The clinical data of 80 patients with NSCLC who received chemotherapy in our hospital from February 2017 to August 2019 were retrospectively analyzed, the occurrence of bone marrow suppression in patients with NSCLC under chemotherapy was enrolled and grouped according to the situation; the clinical data of all patients were collected, the related influencing factors of bone marrow suppression in patients were analyzed. Results Among 80 cases of patients with NSCLC, 45 cases occurred bone marrow suppression, the incidence was 56.25%; after univariate and multivariate Logistic regression analysis, age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis were the influencing factors of bone marrow suppression in patients with NSCLC under chemotherapy (OR>1, P<0.05). Conclusions Age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis will increase the risk of bone marrow suppression in patients with NSCLC chemotherapy. Therefore, reasonable intervention measures can be carried out to reduce the risk.
出版者信息








《广州医药》公众号