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1.
目的 探讨血清淀粉样蛋白A1(SAA1)、脂蛋白结合指数(LCI)对急性冠脉综合征(ACS)患者病情严重程度及预后的评估价值.方法 选取2016年12月至2019年1月我科收治的130例ACS患者作为研究对象(观察组),同时,另选我院体检健康志愿者80例(对照组).比较各组受试者血清SAA1、LCI水平.根据患者出院后6个月是否发生不良心血管事件(MACE)分为预后良好组和预后不良组.采用COX比例风险模型分析影响ACS患者预后的危险因素,采用受试者工作特征曲线(ROC)分析SAA1、LCI对ACS患者短期预后的评估价值.结果 观察组血清SAA1、LCI水平高于对照组,差异有统计学意义(P<0.05).ACS重度组血清SAA1、LCI水平高于中度组、轻度组,中度组血清SAA1、LCI水平高于轻度组,差异有统计学意义(P<0.05).预后不良组患者血清SAA1、LCI水平高于预后良好组患者,差异有统计学意义(P<0.05).COX多因素回归分析结果显示,Genisis评分、SAA1、LCI是影响ACS患者预后的独立危险因素(P<0.05).ROC曲线显示,SAA1、LCI预测ACS患者短期预后的曲线下面积分别为0.821、0.840.结论 ACS患者血清SAA1、LCI水平明显升高,与患者病情严重程度及短期预后密切相关,且对ACS患者预后评估有一定预测价值.  相似文献   

2.
目的:探究三阴性乳腺癌患者BRCA1和BRCA2基因突变检测的临床意义及预后因素分析.方法:研究对象选取为2003年1月至2015年12月之间的三阴性乳腺癌156例,所有患者均通过PCR法和DNA序列测定检验BRCA1和BRCA2基因突变情况,分析乳腺癌患者BRCA1和BRCA2基因突变特点.应用Log-Rank检验对BRCA1和/或BRCA2基因突变的三阴性乳腺癌患者的各项指标如年龄、ECOG状态、临床分期、淋巴结阳性数、月经状态和给药方式进行单因素分析.应用Cox风险比例回归模型分析患者年龄、ECOG状态、临床分期、淋巴结阳性数、肿瘤大小、月经状态和给药方式等多因素分析.结果:三阴乳腺癌患者发生基因突变21例,总体发生率13.46%,BRCA1突变15例,BRCA2突变6例.Log-Rank检验结果显示,发病年龄越大,ECOG评分越高,临床分期越晚,淋巴结阳性数越多,预后越差(P<0.05),而发病时月经状态和给药方式与预后无关.COX风险比例回归模型显示,肿瘤大小(相对危险度,3.163;95%CI:1.455~9.287;P<0.05)和淋巴结转移数(相对危险度,1.859;95%CI:1.254~6.875;P<0.05)是BRCA基因突变三阴性乳腺癌独立的预后因素.结论:BRCA1和BRCA2基因突变可能与乳腺癌尤其是三阴乳腺癌可能有着密切的相关性,发病年龄、ECOG评分,临床分期和淋巴结阳性数及肿瘤大小与BRCA基因突变的三阴乳腺癌预后有关.  相似文献   

3.
目的 探讨介入治疗中晚期非小细胞肺癌(NSCLC)的患者的中性粒细胞/淋巴细胞比值(NLR)与其预后的相关性。方法 回顾性分析我院介入科2014年1月1日~2017年1月1日收治的68例行介入治疗的中晚期非小细胞肺癌患者的临床资料。计算术前NLR值,并通过建立ROC生存曲线分为高NLR组(NLR≥3.8)和低NLR组(NLR<3.8),比较两组的无进展生存时间及总生存时间,同时对可能影响患者预后的危险因素行单因素及多因素分析。结果 所有患者在接受介入治疗后,中位总生存时间为421 d;其中高NLR组中位总生存时间为292 d,低NLR组中位总生存时间为506 d,差异有统计学意义(P<0.05);同时高NLR组中位无进展生存时间为152 d,低NLR组中位无进展生存时间为341 d,差异有统计学意义(P<0.05)。在单因素分析中,存在远处转移、介入手术次数<3次及NLR≥3.8均是影响总生存时间和无进展生存时间的危险因素(P<0.05);在多因素分析中,存在远处转移、NLR≥3.8是影响总生存时间的独立危险因素(P<0.05);存在远处转移、介入手术次数<3次及NLR≥3.8是影响无进展生存时间的独立危险因素(P<0.05)。结论 术前NLR可作为介入治疗中晚期NSCLC患者的预后指标,NLR高者预后差。  相似文献   

4.
目的 基于代谢基因的生物信息学构建肺腺癌预后模型及验证。方法 获取癌症基因组图谱(TCGA)数据库和基因表达数据集(GEO)肺腺癌相关数据,套索(LASSO)回归构建多基因预后模型并计算风险值(RS)。单因素、多因素Cox独立预后分析,通过受试者工作特征(ROC)曲线评价模型的ROC曲线下面积(AUC)并进行生存分析。构建列线图评价模型的可行性,通过基因集富集分析(GSEA)进行代谢基因功能富集分析。肿瘤免疫评估资源(TIMER)数据库分析患者RS与免疫细胞浸润以及与免疫检查点分子表达的相关性。结果 运用TCGA数据库基于18个代谢相关基因构建肺腺癌预后模型,RS可以作为独立的预后因子。ROC曲线下面积为0.713。生存分析显示,与高风险组相比,低风险组总体生存率更高,预后模型与免疫细胞的浸润以及与免疫检查点分子的表达有关。结论 代谢相关基因肺腺癌预后模型的RS是独立预后因子,模型具有较高的预后判断价值。  相似文献   

5.
目的 分析术前外周血中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)联合评分对乳腺癌患者预后的影响及其与临床病理学参数的相关性。方法 选择行根治性乳腺癌手术的患者304例。利用受试者工作特征(ROC)曲线确定NLR及PLR临界值,采用Kaplan-Meier法绘制生存曲线,采用COX回归模型进行单因素和多因素分析,基于生存结局绘制ROC曲线,并对NLR-PLR评分和单一炎症指标的预后价值进行比较。结果 NLR-PLR评分与乳腺癌患者的年龄(P=0. 022)、月经状态(P=0. 026)、肿瘤大小(P=0. 041)、TNM分期(P=0. 028)、淋巴结转移(P=0. 042)和术后放疗(P=0. 002)有关。NLR-PLR评分为0分的患者生存时间与评分为1分、2分的患者生存时间比较,差异均有统计学意义(χ20,1=8. 540,P=0. 003;χ20,2=22. 382,P 0. 001); NLR-PLR评分为1分的患者生存时间与NLR-PLR评分为2分的患者生存时间比较,差异有统计学意义(χ21,2=4. 279,P=0. 039)。单因素分析结果显示肿瘤大小、TNM分期、雌激素受体(ER)、孕激素受体(PR)、淋巴结转移、NLR-PLR评分是影响乳腺癌患者预后的相关因素(P 0. 05);多因素分析结果显示TNM分期、淋巴结转移、NLR-PLR评分是乳腺癌患者预后的独立影响因素(P 0. 05)。NLR-PLR评分的ROC曲线下面积(AUC)大于NLR、PLR和LMR单一炎症指标的AUC(P 0. 001)。结论 NLR-PLR评分与乳腺癌患者临床病理学参数密切相关,是乳腺癌患者预后的独立影响因素,NLR-PLR评分越高的患者生存时间越短。  相似文献   

6.
目的探讨采用液相芯片技术联合检测胃癌多靶标基因的应用价值。方法选取87例拟行手术治疗的胃癌患者为受试者,根据TNM分期分为3组,Ⅰ期19例、Ⅱ期33例、Ⅲ期35例。留取肿瘤组织,采用免疫组织化学染色法检测3类微管蛋白β3(TUBB3)、人表皮生长因子受体2(HER2)、血管内皮细胞生长因子(VEGF)、无催化亚基核酸内切酶ERCC剪切修复基因1(ERCC1)、乳腺癌基因1(BRCA1)、胸苷酸合成酶(TYMS)、亚甲基四氢叶酸还原酶(MTHFR)、微管不稳定蛋白1(STMN1)的表达,采用Luminex液相芯片技术测定上述靶标基因的mRNA水平;随访2年,绘制无瘤生存曲线。结果免疫组织化学染色结果显示不同分期胃癌的ERCC1、TYMS、MTHFR和TUBB3蛋白表达强度无明显差异; BRCA1、STMN1、HER2、VEGF蛋白表达强度存在明显差异,TNM分期越高,BRCA1强度越弱,STMN1、HER2、VEGF强度越强。Luminex液相芯片检测结果显示,不同分期胃癌的ERCC1、TYMS和MTHFR mRNA水平无明显差异; BRCA1、STMN1、TUBB3、HER2、VEGF mRNA水平差异明显,TNM分期越高,BRCA1的mRNA水平越低,STMN1、TUBB3、HER2、VEGF的mRNA水平越高。Log-Rank检验分析结果显示,BRCA1、STMN1、HER2及VEGF的mRNA水平影响患者的无瘤生存期,其中BRCA1高表达者的无瘤生存时间长,STMN1、HER2、VEGF高表达者的无瘤生存时间短。结论多靶标基因联合检测对胃癌患者临床病理分期和预后评估具有一定的指导意义。  相似文献   

7.
目的 探讨动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)患者血清褪黑素(Melatonin)、烟酰胺腺嘌呤二核苷酸磷酸氧化酶4(NOX4)水平及其与患者预后的相关性.方法 选取在我科接受治疗的aSAH患者120例(观察组).另选取我院体检健康者80例(对照组).采用酶联免疫吸附法检测血清Melatonin、NOX4水平.出院6个月后,采用GOS评分评估患者预后情况并将其分为预后不良组(n=42)和预后良好组(n=78),比较2组患者临床资料及血清Melatonin、NOX4水平.采用多因素Logistic回归分析影响aSAH患者预后不良的危险因素.结果 观察组血清Melatonin、NOX4水平高于对照组,差异有统计学意义(P<0.05).aSAH患者治疗后血清Melatonin、NOX4水平低于治疗前,差异有统计学意义(P<0.05).预后不良组血清Melatonin、NOX4水平高于预后良好组,差异有统计学意义(P<0.05).ROC曲线显示,血清Melatonin、NOX4及二者联合检测预测aSAH患者不良预后的AUC分别为0.793、0.834和0.900.多因素Logistic回归分析显示,Hunt-Hess分级Ⅲ~Ⅴ级、改良Fisher分级Ⅲ~Ⅳ级、并发迟发性脑缺血及血清Melatonin、NOX4升高是aSAH患者预后不良的独立危险因素(P<0.05).结论 血清Melatonin、NOX4水平升高与aSAH患者预后不良密切相关,可作为评估aSAH患者临床预后的生物学指标.  相似文献   

8.
目的 探讨血清EB病毒VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平与鼻咽癌患者预后的关系.方法 140例初治无远处转移的鼻咽癌患者分别在治疗前和治疗结束后采用免疫酶法检测血清VCA/IgA和EA/IgA,ELISA法检测NA1/IgA和Rta/IgG.随访进行远期疗效和生存的评价.结果 治疗后患者血清VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平较治疗前有明显下降,但仍显著高于正常对照组(P<0.05).治疗后持续缓解的鼻咽癌患者其治疗前VCA/IgA、EA/IgA抗体水平显著低于疾病进展患者(P<0.05).血清VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平与患者的3年总生存率无关(P>0.05).治疗前VCA/IgA抗体高水平组(≥1∶320)及EA/IgA抗体高水平组(≥1∶80)患者的无进展生存期(61.8%,61.3%)低于抗体低水平组患者(86.5%,86.5%;P<0.001).Cox回归分析显示治疗前VCA/IgA抗体水平是影响无进展生存的独立危险因素(HR=3.80,P=0.001).结论 VCA/IgA、EA/IgA可为鼻咽癌患者预后判断提供帮助.  相似文献   

9.
目的:探讨T淋巴细胞亚群及表皮生长因子受体(Epidermal growth factor receptor,EGFR)与肺腺癌临床特征及预后的关系.方法:选取本院 2019年 10 月至2022年 10 月收治的 72 例肺腺癌患者作为研究对象.比较两组患者肺腺癌病理组织与癌旁组织的CD4+、CD8+和EGFR表达水平,分析其与临床特征的关系.采用受试者工作特征曲线(Receiver Operating Characteristic,ROC)评估CD4+、CD8+和EGFR表达水平对肺腺癌的诊断价值.采用Kaplan-Meier法绘制生存曲线,探讨 T细胞亚群和EGFR表达水平与肺腺癌患者预后的关系.结果:肺腺癌病理组织的CD8+含量及EGFR表达水平均明显高于癌旁组织,而CD4+含量明显低于癌旁组织(P<0.05).CD4+、CD8+含量及EGFR表达水平与淋巴结是否转移和不同TNM分期及分化程度有关(P<0.05).ROC曲线结果显示:CD4+、CD8+和EGFR的AUC值分别为 0.547、0.723、0.757,对肺腺癌患者具有一定的诊断价值.高CD4+含量的生存时间比低 CD4+含量长,高 CD8+含量的生存时间比低 CD8+含量短,EGFR 阳性的生存时间比阴性短.结论:肺腺癌患者的CD8+和EGFR在机体内呈现高表达水平,而CD4+呈现低表达水平,均与患者临床特征和预后密切相关.  相似文献   

10.
目的 检测200例非小细胞肺癌FFPE样本中ERCC1的相对表达量,确定判别ERCC1表达量等级的临界值并对其进行回顾性验证.方法 采用实时荧光定量PCR技术检测FFPE样本中ERCC1和内参基因的表达量,并通过2-ΔCt法计算ERCC1的相对表达量.以其中位值为判别ERCC1表达量等级的临界值,并通过患者应用铂类化疗药物的短期、长期疗效进行回顾性验证.结果 200例FFPE样本中,ERCC1和内参基因均可检出的检出率为89.0%.ERCC1相对表达量与患者年龄、性别、分型、分期及有无吸烟史等差异均无显著性(P>0.05).高表达、低表达ERCC1患者在应用药物后的客观有效率分别为22.0%、53.7% (P <0.05).采用COX模型进行多因素回归分析,发现ERCC1表达量是影响患者无进展生存、总体生存的独立因素(P<0.05).ERCC1高表达、低表达患者接受铂类化疗药物治疗的中位无进展生存时间分别为8个月、14个月,差异有显著性(P=0.018);ERCC1高表达、低表达患者中位总体生存时间分别为10个月、15个月,差异有显著性(P =0.028).结论 判定非小细胞肺癌ERCC1表达量等级的临界值适合进行后续验证,为相关检测标准的制定提供依据.  相似文献   

11.
Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc2 (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.  相似文献   

12.
Renal dysplasia and asplenia in two sibs   总被引:2,自引:0,他引:2  
A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.  相似文献   

13.
About 1900, modern food selection and processing caused widespread epidemics of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a panhypovitaminosis B, i.e., a mixture of substrate beriberi and substrate pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse endemic disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for primates. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.  相似文献   

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15.
Newton H 《Medical history》2011,55(2):153-182
Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.  相似文献   

16.
Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.  相似文献   

17.
HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.  相似文献   

18.
The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.  相似文献   

19.
Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.  相似文献   

20.
Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.  相似文献   

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