论著

基于 BCVA 和角膜水肿程度探讨改良与常规小梁切除术治疗急性闭角型青光眼的临床价值

Based on BCVA and modified with conventional corneal edema degree to explore the clinical value of treatment of acute angle-closure glaucoma trabeculectomy

:366-371
 
       目的   基于最佳矫正视力(BCVA)、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼(AACG)的疗效。方法   回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象,依据1∶1匹配原则,将接受常规小梁切除术的56例患者作为对照组,接受改良小梁切除术的56例患者作为观察组,统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果   术后3个月,观察组视力为(0.63±0.04)logMAR,高于对照组(0.50±0.03)logMAR,眼压为(16.22±2.28)mmHg,低于对照组(19.95±2.31)mmHg(t=19.457、8.600,均P<0.05);观察组浅前房发生率为8.93%,低于对照组的26.79%(χ 2 =6.087,P=0.014);观察组角膜水肿状况优于对照组(Z=2.737,P=0.006);观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%,均低于对照组17.86%、23.21%、32.14%、35.71%(χ 2 =8.166、7.292、3.953、9.818,均P<0.05)。结论   较常规小梁切除术,改良小梁切除术治疗AACG患者,有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生,且安全性较高。
       Objective  To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma(AACG)based on best-corrected visual acuity(BCVA)and degree of corneal edema.Methods  A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects.According to the 1∶1 matching principle,56 patients receiving conventional trabeculectomy were selected as control group,and 56 patients receiving modified trabeculectomy were selected as observation group.Perioperative BCVA,intraocular pressure,postoperative shallow anterior chamber formation,degree of corneal edema and complications were analyzed.Results  At three months postoperatively,visual acuity in the observation group was(0.63±0.04)logMAR,which was higher than that in the control group(0.50±0.03)logMAR,and intraocular pressure was(16.22±2.28)mmHg,which was lower than that in the control group(19.95±2.31)mmHg(t=19.457,8.600,P<0.05);the incidence of shallow anterior chamber in the observation group was 8.93%,which was lower than that of the control group(26.79%)(χ 2 =6.087,P=0.014);the corneal edema status in the observation group was better than that of the control group(Z=2.737,P=0.006);the rates of choroidal detachment,filtering channel obstruction,hyphema,and iris inflammation in the observation group were 1.79%,5.36%,16.07%,and 10.71%,respectively,which were lower than those of the control group(17.86%,23.21%,32.14%,and 35.71%)(χ 2 =8.166,7.292,3.953,and 9.818,P<0.05).Conclusions  Compared with conventional trabeculectomy,modified trabeculectomy can improve visual acuity,reduce intraocular pressure,relieve corneal edema,and reduce the occurrence of shallow anterior chamber in patients with AACG,with higher safety.
论著

类风湿因子、T 淋巴细胞亚群与类风湿关节炎病情程度的关系研究

Relationship between rheumatoid factor,T lymphocyte subsets and the degree of rheumatoid arthritis

:361-365
 
       目的   分析类风湿因子(RF)、T淋巴细胞亚群(CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ )与类风湿关节炎病情程度的关系。方法   选取2023年1月—2024年4月收治的90例类风湿关节炎患者作为观察组,同期到院的90例健康体检者为对照组,均接受RF、CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 检测,并按照类风湿关节炎患者病情评价(DAS28)判定观察组患者病情的严重程度,应用Pearson相关性分析RF、CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 与患者病情严重程度的关系。结果   与对照组比较,观察组RF及CD8+ 水平较高,CD3+ 、CD4+ 及CD4+ /CD8+ 水平较低(P<0.05);不同病情的RF及CD8+ 水平比较,重度患者最高,其次为中度、轻度,而CD3+ 、CD4+ 及CD4+ /CD8+ 水平比较,轻度患者最高,其次为中度、重度,两两比较均有差异统计学意义(P<0.05);经Pearson相关性分析,RF及CD8+ 水平与病情程度呈正相关,CD3+ 、CD4+ 及CD4+ /CD8+ 水平与病情程度呈负相关(P<0.05)。结论  RF、T淋巴细胞亚群指标与类风湿关节炎发生、发展有密切关系,可为医师准确评估患者病情严重程度提供可靠参考。
       Objective  To analyze the relationship between rheumatoid factor(RF),T lymphocyte subsets(CD3+CD4+ ,CD8+ ,CD4+ /CD8+ )and the severity of rheumatoid arthritis.Methods  A total of 90 patients with rheumatoid arthritis from January 2023 to April 2024 were selected as the observation group,and 90 healthy checkup individuals who came to the hospital during the same period were selected as the control group.All patients underwent RF,CD3+ ,CD4+ ,CD8+ ,and CD4+ /CD8+  tests,and the severity of their condition was determined based on the evaluation of rheumatoid arthritis patient condition(DAS28).Pearson Correlation analysis was used to analyze the relationship between RF,CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+  and the disease severity of the patients.Results  Compared with the control group,RF and CD8+  levels in the observation group were higher,while the levels of CD3+ ,CD4+  and CD4+ /CD8+  were low(P<0.05).Comparison of RF and CD8+  levels for different conditions,the RF and CD8+  levels of the severe patients was highest,followed by moderate and mild.However,the CD3+ ,CD4+  and CD4+ /CD8+levels were highest in mild patients,followed by the moderate and sereve patients.Statistical significance was found in both pairwise comparisons(P<0.05).After the Pearson correlation analysis,RF and CD8+  levels were positively correlated with the degree of disease,while CD3+ ,CD4+ ,and CD4+ /CD8+  levels were inversely associated with the degree of disease condition(P<0.05).Conclusions  RF and T lymphocyte subsets are closely related to the occurrence and development of rheumatoid arthritis,and can provide reliable references for physicians to accurately evaluate the severity of patients’ conditions.
论著

风险防范护理干预对控制冠状动脉造影术后患者血管并发症的影响

Effect of risk prevention nursing intervention on controlling vascular complications in patients after coronary angiography

:356-360
 
      目的   探讨在冠状动脉造影术后患者中应用风险防范护理干预对血管并发症的控制效果。方法   选择2022年1月—2023年6月于我院接受治疗的85例冠状动脉造影术后患者。按照随机数字表法分组,其中对照组42例给予常规护理干预,观察组43例给予风险防范护理干预,比较两组干预前后的心理状态、治疗依从性、血管并发症。结果   干预后,观察组正性情绪(PA)评分高于对照组PA评分(t=3.821,P<0.001),观察组负性情绪(NA)评分低于对照组NA评分(t=5.380,P<0.001)。与对照组比,观察组治疗依从性更好(Z=2.268,P=0.023)。观察组血管并发症总发生率低于对照组(9.30% vs 30.95%,χ 2 =6.224,P=0.013)。结论   采用风险防范护理干预,能够改善冠状动脉造影术后患者的心理状态,提高治疗依从性,并降低血管并发症总发生率。
       Objective  To explore the effect of  risk prevention nursing intervention on controlling vascular complications in patients after coronary angiography.Methods  Eighty-five patients after coronary angiography in our hospital were selected from January 2022 to June 2023.They were grouped according to the random number table.And 42 cases were divided into the control group for routine nursing intervention,and 43 cases in the observation group were given risk prevention nursing intervention.Psychological status,treatment compliance and vascular complications of the two groups were observed.Results  After the intervention,the postive affect score of the observation group was higher than that of the control group(t=3.821,P<0.001),and the negative affect score of the observation group(21.25±3.31)was lower than the score of the control group(25.35±3.70)t=5.380,P<0.001).Compared with the control group the compliance of observation group was higher(Z=2.268,P=0.023).The overall incidence of vascular complications in the observation group was lower than that in the control group(9.30% vs 30.95%,χ2=6.224,P=0.013).Conclusions  Risk prevention nursing intervention can improve the psychological status of patients after coronary angiography,improve treatment compliance,and reduce the overall incidence of vascular complications.
论著

一种改良的使用玻璃毛细管进行小鼠玻璃体腔注射方法

An improved method for intravitreal injection in the experimental mouse eye with glass capillary

:350-355
 
       目的   针对目前常规使用的玻璃体腔注射针头容易引起注射后小鼠眼内出血和损伤晶状体的缺陷,本研究采用直径仅0.08 mm的玻璃毛细管作为实验用小鼠眼内注射针头进行玻璃体腔注射,并评估其安全性和可行性。方法  选取12只6-8周的C57BL/6J雄性小鼠,左眼注射磷酸盐缓冲液为实验组,右眼不做特殊处理为对照组。6只小鼠玻璃体腔注射后立即腹腔注射伊文思蓝,检测视网膜血管渗漏情况;另外6只小鼠玻璃体腔注射后24 h处死,视网膜铺片免疫荧光染色小胶质细胞特异性抗体抗离子钙接头蛋白1,分析小胶质细胞的形态变化。结果  实验组和对照组血管与周围荧光强度比值分别为(4.45±0.30)和(4.51±0.24),小胶质细胞数量分别为(131.00±5.38)个/mm2 和(133.00±5.99)个/mm2 ,小胶质细胞胞体面积分别为34.02(27.82,40.54)μm2 和34.70(26.09,40.54)μm2 ,小胶质细胞分支长度分别为198.80(171.30,258.80)μm和223.30(178.20,278.30)μm,两组相比差异均无统计学意义(均P>0.05)。结论   经改良的玻璃毛细管直径更细,损伤更小,可以替代传统的注射针头,可作为实验用小鼠眼内注射针头进行玻璃体腔注射。
       Objective  To assess the safety and feasibility of employing an enhanced glass capillary,with a diameter of 0.08 mm,as an intraocular needle for intravitreal injections in experimental mice eyes.Methods  Twelve male C57BL/6J mice,aged 6-8 weeks,were utilized in this investigation.Phosphate buffered saline(PBS)was administered via intravitreal injection into the left eye of each mouse(experimental group),while the right eye received no special treatment(control group).Six mice received an intraperitoneal injection of Evans blue immediately following intravitreal injection to detect retinal vessel leakage.The remaining six mice were euthanized 24 hours after intravitreal injection,and the retinas were subjected to immunofluorescence staining using a microglia-specific antibody to analyze morphological changes in microglia.Results  In both the experimental and control groups,the ratio of vascular to peripheral fluorescence intensity was(4.45±0.30)and(4.51±0.24),respectively.The number of microglia was(131.00±5.38)/mm2  and(133.00±5.99)/mm2 ,the cell body area of microglia was 34.02(27.82,40.54)μm2  and 34.70(26.09,40.54)μm2 ,and the branch length of microglia was 198.80(171.30,258.80)μm and 223.30(178.20,278.30)μm,respectively.There were no statistically differences observed in any of the above indicators between the two groups(all P>0.05).Conclusions  The use of this glass capillary,characterized by a narrower diameter,reduces tissue damage,demonstrates its potential to replace traditional injection needles for performing intravitreal injections in experimental mice.
论著

ApoE 基因多态性与大动脉粥样硬化型脑梗死及卒中后认知障碍的相关性研究

Correlation of ApoE gene polymorphisms with large artery atherosclerotic cerebral infarction and post-stroke cognitive impairment

:338-345
 
      目的   探讨载脂蛋白E(ApoE)基因多态性与卒中后认知障碍的相关性,即大动脉粥样硬化型脑梗塞的严重程度。方法   采用病例——对照研究的方法,收集九江学院附属医院神经内科的100例急性缺血性脑卒中且病因分型为大动脉粥样硬化型患者(脑梗死组)和50例性别、年龄匹配的非缺血性脑卒中患者(对照组)。检测患者的 ApoE 基因型、血脂、美国国立卫生院卒中量表(NIHSS)、卒中后6个月简易智力状态检查量表(MMSE)等,采用多因素方差分析等统计学方法分析他们之间的关联性。结果  ApoE 3/4基因型频率与Ɛ3、Ɛ4等位基因频率,在脑梗死组别中高于对照组(P<0.05)。同时,携带Ɛ3等位基因患者的低密度脂蛋白水平高于携带Ɛ2、Ɛ4等位基因的患者;进一步分析发现含Ɛ3等位基因的脑梗死患者NIHSS评分更高、卒中后认知障碍更严重(P<0.05)。结论  ApoE基因型为Ɛ3/4、等位基因Ɛ3、Ɛ4更易罹患大动脉粥样硬化型脑梗死,提示该基因型是脑梗死的易感基因,脑梗死后认知障碍患者Ɛ3等位基因的频率较高,可能是卒中后认知障碍的易感因素。
       Objective  To  explore the  relationship  between ApoE  gene  polymorphisms  and  post-stroke  cognitive  impairment,the severity of large artery atherosclerotic cerebral infarction.Methods  A  case-control research  study was conducted,gathering  data from  100 individuals  diagnosed with large artery atherosclerotic cerebral infarction according to the TOAST classification,who admitted to the Neurology Department of the Affiliated Hospital of Jiujiang University.Additionally,50 non-ischemic stroke patients,matched for gender and age,were included as the control group.The patients were assessed for ApoE genotype,blood lipid,NIHSS,and MMSE scale at 6 months post-stroke,and statistical methods were used to analyze their associations.  Results  Significant differences were observed in the ApoE 3/4 genotype frequency and Ɛ3、Ɛ4 allele frequency between patients with cerebral infarction and the control group,with a notably higher incidence of cerebral infarction in the former.Furthermore,patients carrying the Ɛ3 allele exhibited significantly higher LDL levels than those carrying Ɛ2 or Ɛ4.The analysis also revealed that patients with the Ɛ4 allele experienced higher NIHSS and severer post-stroke cognitive impairment.Conclusions  The findings suggest that the ApoE genotype Ɛ3/4 and allele Ɛ3、Ɛ4 may predispose individuals to develop large atherosclerotic cerebral infarction,indicating a susceptibility gene for cerebral infarction.Additionally,the Ɛ3 allele was associated with a higher frequency of cognitive deficits after cerebral infarction,implying that it may be a predisposing factor for post-stroke cognitive impairment.
专家述评

结直肠癌肝转移的分子机制及临床治疗的研究进展

Advances in the emerging mechanisms and treatment progress on liver metastasis of colorectal cancer

:288-299
 
       结直肠癌(CRC)是全球第三大最常见的癌症,也是癌症相关死亡的第二大常见原因。结直肠癌肝转移(CRLM)是导致CRC患者死亡的主要原因,根治性肝切除术是目前有望治愈CRLM的唯一途径,但大部分患者不能进行根治性肝切除术。通过早期发现并进行针对性干预,能够改善患者的治疗效果及预后。文章通过综述CRLM的发病机制、诊疗现状及最新纳米诊疗方法,为深入探索高效诊疗方法提供思路。
      Colorectal cancer(CRC)is the third most common cancer and the second most common cause of cancer-related death worldwide.Colorectal cancer liver metastases(CRLM)are the leading cause of death in patients with CRC.Radical hepatectomy is the only way to cure CRLM so far,while most patients cannot undergo radical hepatectomy.CRLM treatment efficacy and prognosis can be improved by early diagnosis and specialized intervention.This paper reviews the pathogenesis,diagnosis,and treatment status of CRLM and the latest nano-diagnosis and treatment methods so as to provide ideas for in-depth exploration of efficient diagnosis and treatment methods.
医院管理

广东省高水平中医院建设背景下的青年中医人才岗位胜任力现状调查分析

Investigation and analysis of the job competence status of young TCM talents under the background of high level TCM hospital construction in Guangdong Province

:273-281
 
      目的   旨在通过实证了解广东省青年中医人才岗位胜任力现状,探讨青年中医人才岗位胜任力素质特征,为青年中医人才培养提供策略。方法   通过专家咨询制定《青年中医人才岗位胜任力评价框架》并开展问卷调查,采用SPSS 26.0进行数据分析。结果   构建了包含8个一级指标、76个二级指标的《青年中医人才岗位胜任力评价框架》;广东省青年中医人才岗位胜任力自评总分整体处于及格以上水平。女性在职业价值和职业素养、临床技能、交流与沟通技能、管理能力和团队合作、批判性思维与学术科研能力的评分高于男性;不同职称在其他附加维度的评分比较具有统计学差异(P<0.05)。结论   构建的评价框架能够有效评估青年中医人才岗位胜任力;广东省青年中医人才岗位胜任力整体处于及格水平,需重视补强短板;女性青年中医人才岗位胜任力多个维度的得分优于男性,着重提升各人群的弱项维度岗位胜任力;进一步建立健全职称评聘制度,以破五唯为导向构建符合不同级别职称的青年中医人才评价机制。
      Objective  To understand the current job competence status of young TCM talents in Guangdong Province through empirical research,to explore the characteristics of job competence and quality of young TCM talents,providing strategy for cultivating young talents in TCM.Methods The “Competency Evaluation Framework for Young TCM Talents” was developed through expert consultation and a questionnaire survey was conducted.SPSS 26.0 was used for data analysis.Results  “Job Competency Evaluation Framework for Young TCM Talents” was constructed,which included 8 primary indicator items and 76 secondary indicator items.The overall self-evaluation score of the overall job competence of young TCM talents in this study was above the passing level.Female score was higher than male in terms of professional value and professional ethics,clinical skills,communication and interpersonal skills,management ability and teamwork,critical thinking and academic research ability.There were statistically significant differences in the scores of different job titles in other additional dimensions(P<0.05).Conclusions  The constructed evaluation framework can effectively assess the job competence of young TCM talents.The overall competence of young TCM talents in Guangdong Province is at a passing level,and attention  should paid to  strengthening their weaknesses.Female young TCM talents have better multidimensional scores in job competence than males,and efforts should be made to focus on improving the weak dimensional job competence of various groups of people.The professional title evaluation and appointment system needs to be established and improved.A talent evaluation mechanism should be built for young TCM talents that meets different levels of professional titles,guided by the principle of breaking the five criteria.
中医研究

中药自制剂解郁化痰安神颗粒致失眠类瞑眩反应的讨论

Discussion on the insomnia like dizziness reaction caused by self-made traditional Chinese medicine Jieyu Huatan Anshen Granules

:268-272
 
       目的   提示临床在使用解郁化痰安神颗粒过程中,予以关注其发生的药物不良反应,同时进一步重视中成药及中药制剂带来的药物不良反应,并与中医药当中的瞑眩反应予以区分。方法   通过分析1例解郁化痰安神颗粒致失眠不良反应,基于中国知网、万方数据知识服务平台等国内数据库,对不良反应发生机制予以分析、讨论。结果   本次解郁化痰安神颗粒致失眠不良反应1例,不良反应相关性评价为“可能”,根据临床观察,可能为中药中典型的“瞑眩反应”。论   临床当发现基于中成药的不良反应,应予以分析辨别,及时处置药物不良反应,进一步观察研究瞑眩反应。
       Objective  To suggest that during the clinical use of Jieyu Huatan Anshen Granules,attention should be paid to its adverse drug reactions,and further attention should be paid to the adverse drug reactions caused by traditional Chinese patent medicines and simple preparations and traditional Chinese medicine preparations,and it should be distinguished from the insomnia and dizziness reactions in traditional Chinese medicine.Methods  A case of insomnia adverse  reaction caused by Jieyu Huatan Anshen Granules was analyzed based on domestic databases such as CNKI and Wanfang data to investigate and discuss the mechanism of adverse reactions.Results  One case of insomnia adverse reaction caused by Jieyu Huatan Anshen Granules was reported,and the correlation evaluation of the adverse reaction was “possible”.According to clinical observations,it may be a typical “dizziness reaction” in traditional Chinese medicine.Conclusions  When adverse reactions based on traditional Chinese medicine decoction,traditional Chinese patent medicines and simple preparations and other traditional Chinese medicine preparations are found in clinical practice,they should be analyzed and identified,and the adverse reactions should be handled in time and be further observed and studied.
综述

大柴胡汤合大承气汤在急性胰腺炎治疗中的研究进展

Research progress on Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis

:252-259
 
       急性胰腺炎(AP)是一种常见的消化系统急症。随着生活水平的提高,其重症发病率也逐年增加。中西医结合治疗急性胰腺炎在临床实践中展现出优势。近年来,大柴胡汤合大承气汤在治疗急性胰腺炎方面药理机制的研究不断延伸,同时对方药中的药理活性成分也在不断深入研究。该文旨在整理相关研究,综述大柴胡汤合大承气汤治疗急性胰腺炎的理论基础、临床应用、药物活性成分、药理机制等,以期为临床实践和进一步深入研究提供参考。
        Acute pancreatitis(AP)is a common gastrointestinal emergency.With the improvement of living standards,the incidence of severe AP has been increasing year by year.The combined treatment of traditional Chinese and Western medicine has shown advantages in the clinical practice of acute pancreatitis.In recent years,the pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis has been continuously studied,and the pharmacological active components in the prescription are also being explored.This article aims to summarize  relevant  research on the theoretical basis,clinical application,active ingredients and pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis,providing reference for clinical practice and further research.
论著

ZEB1、LAMP5 在结直肠癌组织中的表达水平分析及预后预测价值分析

Expression levels and prognostic value of ZEB1 and LAMP5 in colorectal cancer tissues

:228-234
 
       目的  探讨转录因子E盒结合锌指蛋白1(ZEB1)、溶酶体相关膜蛋白5(LAMP5)在结直肠癌组织中的表达水平分析及预后预测价值。方法  选取驻马店市中心医院2018年1月—2020年1月收治的120例结直肠癌患者,分别采取所有患者的结直肠癌组织及癌旁组织进行免疫组化染色,对比ZEB1、LAMP5阳性率。对比不同病理特征结直肠癌患者ZEB1、LAMP5表达水平差异。对所有患者进行4年随访,依照随访结果将患者分为2个亚组,即预后不良组(n=35)和预后良好组(n=85),对比两组患者一般临床特征及ZEB1、LAMP5表达水平,应用Logistic回归分析ZEB1、LAMP5对结直肠癌预后的预测价值。结果 结直肠癌组织ZEB1、LAMP5相对表达量(38.26±5.49、26.77±3.85)与ZEB1、LAMP5阳性率(86.67%、72.22%)高于癌旁组织(15.46±2.54、8.04±1.59、23.33%、15.56%],对比差异有统计学意义(t=41.280,χ2=25.437;t=49.255,χ 2 =16.071;P<0.05)。不同TNM分期[Ⅰ~Ⅱ期(35.55±4.13)、Ⅲ~Ⅳ期(42.32±4.75)]、淋巴结转移患者[是(44.37±4.28)、否(35.84±3.77)]、肿瘤分化程度[低分化(35.27±4.57)、中高分化(41.34±4.60)]ZEB1相对表达量对比差异有统计学意义(t=-8.281,P<0.001;t=10.746,P<0.001;t=-7.253,P<0.001);不同TNM分期[Ⅱ期(24.88±3.37)、Ⅲ~Ⅳ期(29.61±2.57)]、淋巴结转移[是(30.72±2.19)、否(25.21±3.19)]、肿瘤分化程度[低分化(24.57±3.62)、中高分化(29.04±2.55)]患者LAMP5相对表达量对比差异有统计学意义(t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001);预后良好组与预后不良组患者性别、年龄、大体类型、肿瘤大小对比差异无统计学意义(P>0.05),预后良好组与预后不良组患者TNM分期、淋巴结转移、肿瘤分化程度、ZEB1、LAMP5阳性比例对比差异有统计学意义(P<0.05);Logistic回归分析显示:淋巴结转移、ZEB1阳性、LAMP5阳性为结直肠癌预后不良独立预测因素(P<0.05)。结论  ZEB1、LAMP5在结直肠癌组织中呈现高表达状态,且与结直肠癌的发生有关,同时ZEB1、LAMP5是结直肠癌预后的独立预测因素,两者有希望成为结直肠癌的治疗靶点。
       Objective  To investigate the expression levels and prognostic value of transcription factor E-box binding to zinc finger protein 1(ZEB1)and lysosomal associated membrane protein 5(LAMP5)in colorectal cancer tissues.Methods  A total of 120 colorectal cancer patients admitted to a hospital from January 2018 to January 2020 were selected.Immunohistochemical staining was performed on the colorectal cancer tissues and adjacent tissues of all patients,and the positivity rates of ZEB1 and LAMP5 were compared.The expression levels of ZEB1 and LAMP5 in colorectal cancer patients with different pathological characteristics were compared.All patients were followed up for 4 years and divided into two subgroups based on the follow-up results,namely the poor prognosis group(n=35)and the good prognosis group(n=85).The general clinical characteristics and expression levels of ZEB1 and LAMP5 were compared between the two groups.Logistic  regression analysis was used to evaluate the predictive value of ZEB1 and LAMP5 for the prognosis of colorectal cancer.Results The relative expression level of ZEB 1 and LAMP 5 in colorectal cancer tissues [(38.26±5.49),(26.77±3.85)] and the positive rate of ZEB 1 and LAMP 5(86.67%,72.22%)were significantly higher than that of adjacent tissues [(15.46±2.54),(8.04±1.59),23.33%,15.56%],the contrast  difference was statistically significant(t=41.280,χ2=25.437;t=49.255,χ 2 =16.071;P<0.05).Relative ZEBI expression levels in different TNM stages [I-Ⅱstage(35.55±4.13),Ⅲ-Ⅳstage(42.32±4.75)],lymph node metastasis[Yes(44.37±4.28),No(35.84±3.77)],degree of tumor differentiation [hypodifferentiated(35.27±4.57),and middle or high differentiated (29.04±2.55)],those differences were statistically significant(t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001).The relative expression of LAMP 5 between different TNM stages [I-Ⅱstage(24.88±3.37),Ⅲ-Ⅳstage(29.61±2.57)],lymph node metastasis [yes(30.72±2.19),no(25.21±3.19)],degree of tumor  differentiation [hypodifferentiated(24.57±3.62),and middle or high differentiated(29.04±2.55)],the contrast was statistically significant(t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001).There were no differences in gender,age,gross type,and tumor size between the good prognosis group and the poor prognosis group(P>0.05),while there were differences in TNM stages,lymph node metastasis,tumor differentiation degrees,ratio of ZEB 1 and LAMP 5(P<0.05).Logistic regression analysis showed that TNM stage,lymph node metastasis,ZEB 1 positive,and LAMP 5 positive were independent predictive factors of poor prognosis in colorectal cancer(P<0.05).Conclusions  ZEB1 and LAMP5 are highly expressed in colorectal cancer tissues and closely related to the occurrence and development of colorectal cancer.ZEB1 and LAMP5 are independent prognostic factors for colorectal cancer,and they have the potential to become therapeutic targets for colorectal cancer.
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