基于肿瘤浸润深度及大小的TTS 评分系统对可切除胃癌患者预后判断的价值

目的:探讨基于肿瘤浸润深度及大小的TTS评分系统对可切除胃癌患者预后判断的价值。方法:选择行根治性切除的234例胃癌患者为研究对象。根据肿瘤浸润深度（T分期）和肿瘤大小构建TTS评分系统，分为TTS 0级、1级、2级，代表肿瘤侵袭性逐渐升高。通过Cox多因素模型分析TTS评分系统作为预后判断工具的可行性。结果:T1-T4期患者肿瘤的平均大小分别为(3.3±2.7)cm、(4.1±3.1)cm、(6.6±3.1)cm、(9.4±4.9)cm。单因素分析显示，肿瘤浸润深度与肿瘤大小、淋巴结转移、TNM分期、淋巴浸润和血管浸润显著相关(P＜0.01)。ROC曲线显示，45 mm为肿瘤大小的最佳界值，可有效区分患者是否存在淋巴结转移，曲线下面积(area under curve,AUC)为0.762。综合肿瘤大小的临界值和肿瘤浸润深度，构建TTS评分系统,TTS 0级、TTS 1级和TTS 2级的患者5年生存率分别为95.6%、83.3%和70.2%，两两比较后发现，不同TTS状态患者的生存率之间均存在显著差异(P＜0.01)。Cox多因素分析发现，TTS评分是影响患者预后的独立性危险因素（P＜0.05）。结论:本研究根据肿瘤浸润深度和大小构建了TTS评分系统，并证明了TTS评分与胃癌患者的预后密切相关。     

Biomolecular alterations in the early life stages of four food fish following acute exposure of Triclosan

We investigated the effect of acute concentrations of triclosan (TCS; 96 h exposure and 10d post exposure) on the free amino acid, primary (SDS-PAGE) and secondary (FT-IR) structure of proteins in the embryos/larvae of Cyprinus carpio, Ctenopharyngodon idella, Labeo rohita and Cirrhinus mrigala. A concentration dependent increase in free amino acids, upregulation of polypeptides (100 and 70 kDa in C. carpio, C. idella and L. rohita, 55, 45, 36 kda in C. idella and L. rohita and 22 kDa in all the fish) and a decline in percent area of all the selected peaks of the FT-IR spectra was observed after exposure and recovery period. The decline in percent area was greatest for L. rohita at peak 1080 – 1088 cm⁻¹ (−75.99%) after exposure and at peak 2854 – 2855 cm⁻¹ (−53.59%) after recovery. Curve fitting analysis revealed a decrease in α-helices and increase in β-sheets in all fish after exposure and recovery period. The results suggest that TCS elicits alterations in biomolecules of fish embryos.     

Burn survivors injured as children exhibit resilience in long-term community integration outcomes: A life impact burn recovery evaluation (LIBRE) study

IntroductionThere is limited understanding of how burn injuries at different ages are associated with normal growth and development as well as the burn recovery process. This study provides new useful insights by comparing social participation outcomes among burn survivors injured in childhood compared with injuries sustained in middle age, and older adulthood.MethodsItems from the development of the LIBRE profile were administered to 601 adult burn survivors with ≥5% TBSA burned or burns to critical areas (hands, feet, face, or genitals). Each item was answered on a 5-point Likert scale with higher scores denoting better outcomes. Mean scores for the 6 LIBRE profile scales (sexual relationships, family and friends, social interactions, social activities, work and employment, and romantic relationships) were compared between those burned as children (<18 years) and those burned as adults (≥18 years). Regression analyses were used to assess differences between groups with adjustment for demographic and clinical characteristics.ResultsOf the 597 burn survivors having complete data on age at injury, 165 (27.6%) sustained burn injuries as a child. Those burned as children were more frequently female than those burned as adults (57% vs 47%) and were also more frequently white non-Hispanic (89% vs 77%). Marital status and education level were similar in the two groups. Those who were burned as children had slightly higher scores on the social activities, work and employment and romantic relationships scales. However, these differences did not persist in adjusted regression analyses.ConclusionsBurn survivors who sustained injuries as a child fared at least as well as those burned as adults in a broad range of long-term social participation outcomes. The impact on long-term social participation outcomes of burn survivors was not significantly different between individuals with burns sustained during important developmental stages at young ages and those injured later in life.     

胆囊癌切除范围研究进展

胆囊癌是胆道系统最常见的恶性肿瘤，早期诊断困难，恶性程度高，易发生转移和复发。以手术为主的综合治疗是改善胆囊癌病人生存的唯一方法，但仍存在若干争议，如T2期是否需要行肝段切除、扩大根治术是否可以延长晚期胆囊癌病人的生存时间、各期胆囊癌淋巴结清扫范围等。结合术中所见、病理学检查等判断胆囊癌的肿瘤分期，并依据分期规范切除范围和淋巴结清扫是提高R0根治切除率的关键，且扩大根治术可以改善晚期病人的预后。     

Profiles of immune cell infiltration and their clinical significance in head and neck squamous cell carcinoma

It is well established that there exist comprehensive interactions between tumor immunology and tumor biology. Tumor-infiltrating immune cells (TIICs) have been appealing therapeutic targets due to their significance in regulating cancer progression. The purpose of this study was to illustrate the comprehensive landscape of TIICs composition in head and neck squamous cell carcinoma (HNSCC) and their clinical significance. CIBERSORT was applied to calculate the 22 immune cell types proportion in HNSCC and further analysis suggested that six kinds of immune cells (resting memory CD4 T cells, M1 macrophages, resting dendritic cells, resting mast cells, monocytes, and eosinophils) were closely correlated with HNSCC progression. Moreover, memory CD4 T cells may serve as prognosis indicator for HNSCC patients. Collectively, this study uncovered the immune cells infiltration landscape in HNSCC and illustrated their potential relationships with clinical parameters, thereby contributing to the development of customized treatment strategy.     

从母胎界面着眼探究子痫前期的发病机制

        子痫前期（pre-eclampsia，PE）是指妊娠20周以后出现的新发高血压伴多系统受累和损害的综合征。在世界范围内，每年子痫前期可造成大于50万新生儿和胎儿以及大于7万孕产妇死亡，全球发病率约2%～8%［1］。而重度子痫前期可继发出现溶血、肝酶升高、血小板减少等，即HELLP综合征，导致全身多个系统器官损害。子痫前期是多种因素共同作用所致，因此应该从多角度、多机制探究子痫前期的分子病理学基础，方有可能实现PE的早期预测和预防。 浏览更多请关注本刊微信公众号及当期杂志。