胸水及血清中透明质酸水平在肺癌与肺良性疾病中的鉴别诊断意义

目的分析胸水及血清透明质酸(HA)水平在肺癌与肺良性疾病中的鉴别诊断意义。 方法选取我院2019年5月至2021年9月收治的37例肺癌患者为观察组，选取我院同期住院治疗的32例肺部良性病变为对照组。入院24 h内采集胸水及血液标本分别检HA水平；以磁微粒化学发光法检测血清鳞状上皮细胞癌抗原(SCC)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)及细胞角蛋白19片段抗原21-1(CYFRA21-1)。比较两组胸水及血清中HA水平。 结果观察组胸水及血清HA水平高于对照组(P<0.05)。观察组胸水CEA、ADA高于对照组(P<0.05)。胸水CEA及ADA水平、胸水及血清HA、肿瘤标志物表达高，为影响肺癌患者发生的相关因素(P<0.05)。 结论肺癌患者胸水CEA及ADA水平、胸水及血清HA、肿瘤标志物五项SCC、CA125、NSE、CEA、CYFRA21-1水平呈异常表达，对肺癌具有鉴别诊断意义。     

Anästhesiologisches Management bei operativen Eingriffen am Thorax – eine Auswertung aus dem Deutschen Thoraxregister

Die Anaesthesiologie - Während zahlreiche Kliniken in Deutschland thoraxchirurgische Eingriffe durchführen, liegen bisher nur unzureichende Daten über die verwendeten...     

Review of clinical characteristics,immune responses and regulatory mechanisms of hepatitis E-associated liver failure

Hepatitis E virus (HEV) is the most common cause of acute liver failure (LF) and one of the most common factors causing acute injury in acute-on-chronic LF (ACLF). When HEV-related LF occurs, a series of changes take place in both the intrahepatic environment and extrahepatic microenvironment. The changed types and distribution of immune cells (infiltrating macrophages and increased lymphocytes) in liver tissue, as well the increased proinflammatory cytokines and chemokines in the blood, indicate that the occurrence and progression of HEV-related LF are closely related to immune imbalance. The clinical features and immune reaction in the body during HEV-related acute LF (ALF) and ACLF are complicated. This review highlights recent progress in elucidating the clinical manifestations of HEV-associated ALF and ACLF and discusses the corresponding systemic immune changes and possible regulatory mechanisms.     

PREDICT-GTN 1: Can we improve the FIGO scoring system in gestational trophoblastic neoplasia?

Gestational trophoblastic neoplasia (GTN) patients are treated according to the eight-variable International Federation of Gynaecology and Obstetrics (FIGO) scoring system, that aims to predict first-line single-agent chemotherapy resistance. FIGO is imperfect with one-third of low-risk patients developing disease resistance to first-line single-agent chemotherapy. We aimed to generate simplified models that improve upon FIGO. Logistic regression (LR) and multilayer perceptron (MLP) modelling (n = 4191) generated six models (M1-6). M1, all eight FIGO variables (scored data); M2, all eight FIGO variables (scored and raw data); M3, nonimaging variables (scored data); M4, nonimaging variables (scored and raw data); M5, imaging variables (scored data); and M6, pretreatment hCG (raw data) + imaging variables (scored data). Performance was compared to FIGO using true and false positive rates, positive and negative predictive values, diagnostic odds ratio, receiver operating characteristic (ROC) curves, Bland-Altman calibration plots, decision curve analysis and contingency tables. M1-6 were calibrated and outperformed FIGO on true positive rate and positive predictive value. Using LR and MLP, M1, M2 and M4 generated small improvements to the ROC curve and decision curve analysis. M3, M5 and M6 matched FIGO or performed less well. Compared to FIGO, most (excluding LR M4 and MLP M5) had significant discordance in patient classification (McNemar's test P < .05); 55-112 undertreated, 46-206 overtreated. Statistical modelling yielded only small gains over FIGO performance, arising through recategorisation of treatment-resistant patients, with a significant proportion of under/overtreatment as the available data have been used a priori to allocate primary chemotherapy. Streamlining FIGO should now be the focus.     

石河子地区近十年结肠镜成人结直肠癌及腺瘤检出情况的横断面调查

目的　调查石河子地区近十年结肠镜下成人结直肠癌（colorectal cancer，CRC）、结直肠腺瘤和进展期腺瘤检出率的变化趋势。方法　2010年1月1日—2019年12月31日期间，就诊于石河子大学医学院第一附属医院完成结肠镜检查的病例纳入调查，通过查阅电子病历系统收集病历资料，具体信息包括患者年龄、性别及结直肠腺瘤或CRC的部位、数量、大小和病理类型等。主要观察结直肠腺瘤、结直肠进展期腺瘤和CRC的检出率，包括10年总体检出率以及前五年（2010—2014年）总体检出率和后五年（2015—2019年）总体检出率。结果　共纳入50 645例，经排除标准排除14 931例，最终共35 714例纳入数据分析。结直肠腺瘤、结直肠进展期腺瘤和CRC的10年总体检出率分别为17.65%（6 302/35 714）、4.45%（1 589/35 714）和3.71%（1 324/35 714）。结直肠腺瘤后五年总体检出率［20.33%（4 565/22 457）］高于前五年［13.10%（1 737/13 257）］；结直肠进展期腺瘤后五年总体检出率［4.69%（1 053/22 457）］高于前五年［4.04%（536/13 257）］；CRC后五年总体检出率［3.30%（741/22 457）］低于前五年［4.40%（583/13 257）］。结论　石河子地区2015—2019年结直肠腺瘤检出率较2010—2014年有较大幅度升高，结直肠进展期腺瘤检出率较2010—2014年有小幅升高，而CRC检出率较2010—2014年有小幅下降，由此推测结肠镜检查发现并切除结直肠腺瘤对降低CRC发病率可能具有重要作用。     

Small nucleolar RNA host gene 3 functions as a novel biomarker in liver cancer and other tumour progression

Cancer has become the most life-threatening disease in the world. Mutations in and aberrant expression of genes encoding proteins and mutations in noncoding RNAs, especially long noncoding RNAs (lncRNAs), have significant effects in human cancers. LncRNAs have no protein-coding ability but function extensively in numerous physiological and pathological processes. Small nucleolar RNA host gene 3 (SNHG3) is a novel lncRNA and has been reported to be differentially expressed in various tumors, such as liver cancer, gastric cancer, and glioma. However, the interaction mechanisms for the regulation between SNHG3 and tumor progression are poorly understood. In this review, we summarize the results of SNHG3 studies in humans, animal models, and cells to underline the expression and role of SNHG3 in cancer. SNHG3 expression is upregulated in most tumors and is detrimental to patient prognosis. SNHG3 expression in lung adenocarcinoma remains controversial. Concurrently, SNHG3 affects oncogenes and tumor suppressor genes through various mechanisms, including competing endogenous RNA effects. A deeper understanding of the contribution of SNHG3 in clinical applications and tumor development may provide a new target for cancer diagnosis and treatment.     

An aid to patient positioning after vitrectomy surgery

Graefe's Archive for Clinical and Experimental Ophthalmology -