What is the impact of zinc deficiency for pancreatectomies in patients with pancreatic ductal adenocarcinoma?

Backgroundand purpose: Zinc is an essential element for human health and plays an important role in metabolic, immunological and other biological processes. The present study was conducted to investigate the association between zinc deficiency (ZD) and the perioperative clinical course in patients with pancreatic ductal adenocarcinoma (PDAC).MethodsOf 216 patients with PDAC who underwent elective pancreatectomy between 2013 and 2017 at our institution, 206 patients with sufficient clinical data were retrospectively reviewed. The perioperative variables were compared and the risk factors associated with infectious complications were identified.ResultsZD was preoperatively present in 36 (17.5%) of 206 patients with PDAC. In the patients of the ZD group, a higher proportion of males, higher preoperative modified Glasgow prognostic scores, a higher neutrophil-to-lymphocyte ratio, and a higher occurrence of postoperative infectious complications after pancreatectomy were observed, compared to the non-ZD group. By a univariate analysis, three risk factors were significantly associated with infectious complications after pancreatectomy: ZD (vs non-ZD: p = 0.002), serum albumin <3.5 g/dl (vs ≥ 3.5 g/dl: p = 0.005), and the procedure of pancreaticoduodenectomy (vs others: p = 0.013). By multivariate logistic regression analysis, the occurrence of infectious complications was significantly associated with ZD (OR 3.430, 95%CI 1.570 to 7.490, p = 0.002) and the procedure of pancreaticoduodenectomy (OR 2.030, 95%CI 1.090 to 3.770, p = 0.025).ConclusionsThe current study newly demonstrated that ZD could serve as a preoperative predictor of infectious complications after pancreatectomies in the patients with PDAC.     

术前血清CA125、HE4和中性粒细胞与淋巴细胞比值联合检测在子宫内膜癌诊断中的作用

目的:探讨血清糖类抗原125（carbohydrate antigen 125，CA125）、人附睾蛋白4（human epididymis protein 4，HE4）、中性粒细胞与淋巴细胞比值（neutrophil-lymphocyte ratio，NLR）联合检测在子宫内膜癌诊断中的作用。方法:选取42例子宫内膜癌患者、50例子宫内膜良性疾病患者和50例健康体检人群。采用SYSMEX XN550全自动血液分析仪计数术前外周血中性粒细胞和淋巴细胞，计算NLR；采用Maglumi4000全自动化学发光仪检测术前血清CA125、HE4水平。采用ROC曲线分析CA125、HE4、NLR和三者联合指标在诊断子宫内膜癌中的作用。结果:外周血NLR在健康组、良性组和子宫内膜癌组中逐渐增高，且差异有统计学意义（P<0.05）；子宫内膜癌组HE4表达量显著高于良性组与健康组（P<0.05），而良性组与健康组之间差异无统计学意义（P>0.05）；CA125表达量在三组中差异无统计学意义（P>0.05）。CA125、HE4、NLR及三者联合标记物的AUC分别为0.530、0.733、0.795、0.823，当分别取它们的临界值时，特异性分别为70.8%、85.1%、61.7%、83.0%，敏感性分别为40.0%、63.3%、86.7%、73.3%。单项指标NLR的敏感性最高，HE4的特异性最高，联合指标的特异性和敏感性都很高。结论:术前血清CA125、HE4和NLR联合检测具有较高的特异性和敏感性，联合检测可以互为补充，提高子宫内膜癌的诊断准确率，对子宫内膜癌的诊断具有指导意义。     

Interplay between bile acids and the gut microbiota promotes intestinal carcinogenesis

The gut microbiota and the bile acid pool play pivotal roles in maintaining intestinal homeostasis. Bile acids are produced in the liver from cholesterol and metabolized in the intestine by the gut microbiota. Gut dysbiosis has been reported to be associated with colorectal cancer. However, the interplay between bile acid metabolism and the gut microbiota during intestinal carcinogenesis remains unclear. In the present study, we investigated the potential roles of bile acids and the gut microbiota in the cholic acid (CA; a primary bile acid)‐induced intestinal adenoma‐adenocarcinoma sequence. Apc ^min/+ mice, which spontaneously develop intestinal adenomas, were fed a diet supplemented with 0.4% CA for 12 weeks. Mice that were fed a normal diet were regarded as untreated controls. In CA‐treated Apc ^min/+ mice, the composition of the gut microbiota was significantly altered, and CA was efficiently transformed into deoxycholic acid (a secondary bile acid) by the bacterial 7α‐dehydroxylation reaction. The intestinal adenoma‐adenocarcinoma sequence was observed in CA‐treated Apc ^min/+ mice and was accompanied by an impaired intestinal barrier function and IL‐6/STAT3‐related low‐grade inflammation. More importantly, microbiota depletion using an antibiotic cocktail globally compromised CA‐induced intestinal carcinogenesis, suggesting a leading role for the microbiota during this process. Overall, our data suggested that the crosstalk between bile acids and the gut microbiota mediated intestinal carcinogenesis, which might provide novel therapeutic strategies against intestinal tumor development.     

血清CEA、CA72-4及CA125联合诊断胃癌术后腹膜转移

目的:探讨血清CEA、CA72-4及CA125联合诊断胃癌术后腹膜转移的价值，为临床诊治提供参考。方法:以我院于2015年11月至2016年11月因胃癌术后在本院复查且相关临床资料齐全患者120例作为研究对象并进行回顾性分析，按照有无腹膜转移分为转移组（38例）和无转移组（82例）。对比两组患者的血清CEA、CA72-4及CA125变化及单项诊断效能，并采用ROC曲线法对比三种肿瘤标志物的诊断效能。结果:转移组患者的血清CEA、CA72-4及CA125水平均高于无转移组，差异有统计学意义（P＜0.05）。三个单项指标比较，CA125灵敏度为73.3%，特异度为81.8%，均为三者最高，差异均有统计学意义（P＜0.05）。联合诊断比较，CEA+CA72-4+CA125联合检测的灵敏度最高（91.7%），但特异度最低（41.7%），差异均有统计学意义(P＜0.05)。结论:胃癌术后腹膜转移患者血清CEA、CA72-4及CA125均升高，且单项诊断CA125的灵敏度及特异度最高，而三项联合诊断的灵敏度最高，但特异度最低，值得临床参考。     

The Effect of Weight Change During Treatment With Targeted Therapy in Patients With Metastatic Renal Cell Carcinoma

BackgroundThe relationship between weight change during treatment and survival remains poorly characterized in patients with metastatic renal cell carcinoma (mRCC).Patients and MethodsIn this retrospective analysis we included 3311 patients with mRCC treated in phase II/III first-line or second-line targeted therapy clinical trials and assessed the effect of weight change on overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) at 6 and 12 weeks from treatment initiation. Weight change was defined as weight loss (≥5% reduction), weight gain (≥2% increase), or stable weight from baseline. Survival analyses were performed using the Kaplan–Meier method and adjusted for known prognostic factors using Cox regression multivariable analysis.ResultsOverall, 1916 (58%) had stable weight, 936 (28%) had weight loss, and 459 (14%) had weight gain at 12 weeks. Patients with weight loss at 12 weeks had inferior OS compared with those with stable weight (hazard ratio [HR], 1.494; 95% confidence interval [CI], 1.322-1.688; P < .0001; median OS 18.7 vs. 26.9 months), and shorter PFS (HR, 1.315; 95% CI, 1.189-1.455; P < .0001; median PFS, 7.2 vs. 10.1 months). The ORRs for patients with weight loss, stable weight, and weight gain at 12 weeks were 23.4% (n = 219/936), 32.1% (n = 615/1916), and 35.9% (n = 165/459), respectively (adjusted odds ratio, 0.715; P = .03). Findings were consistent at 6 weeks. Adverse events were similar between groups.ConclusionWe showed that mRCC patients who experience weight loss during treatment have worse outcomes compared with patients with stable weight at 6 and 12 weeks of treatment. Weight loss at 6 weeks from treatment initiation might be an early clinical biomarker of worse survival and might provide prognostic utility.     

miR-125b-5p对喉鳞状细胞癌细胞能量代谢及增殖的影响

目的  探讨miR-125b-5p对喉鳞状细胞癌（laryngeal squamous cell carcinoma，LSCC）细胞能量代谢和增殖的影响及其可能的作用机制。方法 实验分为miR-125b-5p转染组（miR-125b-5p模拟物转染LSCC）和对照组（空质粒转染LSCC细胞）。采用RT-qPCR 检测miR-125b-5p在正常支气管上皮细胞和LSCC细胞中的表达，CCK-8和流式细胞术检测LSCC细胞增殖、凋亡情况，Western blot检测miR-125b-5p过表达后LSCC中HK2的表达，3H-2DG法和乳酸盐比色测定实验分别检测LSCC细胞葡萄糖消耗和乳酸产生的情况。结果 RT-qPCR实验结果显示，与正常支气管上皮细胞相比，LSCC细胞中miR-125b-5p的表达降低（0.68±0.03 vs 0.22±0.05，t=7.025，P=0.001）。CCK-8实验结果显示，转染72 h和96 h后，miR-125b-5p转染组LSCC细胞的增殖能力均较对照组明显降低（P<0.05）。流式细胞术检测结果显示，miR-125b-5p转染组LSCC细胞凋亡率较对照组升高 ［（37.52±2.34）% vs （12.46±3.52）%，t=7.025，P<0.001）］，但细胞集落形成能力降低（0.29±0.02 vs 1.02±0.03，t=5.689，P=0.005）；荧光素酶报告基因测定实验结果显示，miR-125b-5p转染组的荧光素酶活性低于对照组（0.32±0.03 vs 1.01±0.02，t=7.543，P=0.001）；Western blot法实验结果显示，miR-125b-5p转染组HK2蛋白表达水平较对照组降低（0.12±0.02 vs 0.75±0.03，t=5.875，P=0.023）；miR-125b-5p转染组葡萄糖消耗量［（3.85±0.86） dpm/mg vs （10.52±1.34） dpm/mg，t=6.118，P=0.005］以及乳酸产生量［（4.23±1.36） dpm/mg vs （10.96±2.45） dpm/mg，t=5.907，P=0.002］亦较对照组降低。结论 miR-125b-5p可能通过下调HK2表达降低喉鳞状细胞癌细胞的能量代谢和增殖能力，诱导细胞凋亡。     

曼月乐治疗子宫内膜异位症的效用分析

目的:探讨曼月乐对子宫内膜异位症的治疗效果。方法:选取98例我院在2015年12月—2018年12月收治的子宫内膜异位症患者进行研究,按照入院顺序分成对照组和观察组,各49例。对照组用妈富隆治疗,观察组用曼月乐治疗,比较两组治疗情况。结果:观察组疾病治疗总有效率高于对照组,不良反应发生率低于对照组(95.92%VS79.59%,6.12%VS22.45%)(P<0.05);两组治疗前疼痛程度、子宫内膜厚度、糖类抗原125水平对比差异无统计学意义(P>0.05),观察组治疗后痛程度、子宫内膜厚度、糖类抗原125水平低于对照组[(4.98±1.09)分VS(5.72±1.32)分,(0.58±0.15)cmVS(0.68±0.16)cm,(59.34±1.81)U/mLVS(60.28±1.76)U/mL](P<0.05)。结论:在子宫内膜异位症的治疗中使用曼月乐,可提高治疗效果,缓解疼痛感,降低不良反应发生风险,推广应用价值高。