The prognostic value of platelet-to-lymphocyte ratio on the long-term renal survival in patients with IgA nephropathy

Purpose

Platelet-to-lymphocyte ratio (PLR) was established showing the poor prognosis in several diseases, such as malignancies and cardiovascular diseases. But limited study has been conducted about the prognostic value of PLR on the long-term renal survival of patients with Immunoglobulin A nephropathy (IgAN).

Methods

We performed an observational cohort study enrolling patients with biopsy-proven IgAN recorded from November 2011 to March 2016. The definition of composite endpoint was eGFR decrease by 50%, eGFR?<?15 mL/min/1.73 m², initiation of dialysis, or renal transplantation. Patients were categorized by the magnitude of PLR tertiles into three groups. The Kaplan–Meier curves and multivariate Cox models were performed to determine the association of PLR with the renal survival of IgAN patients.

Results

330 patients with a median age of 34.0 years were followed for a median of 47.4 months, and 27 patients (8.2%) had reached the composite endpoints. There were no differences among the three groups (PLR?<?106, 106?≤?PLR?≤?137, and PLR?>?137) in demographic characteristics, mean arterial pressure (MAP), proteinuria, and estimated glomerular filtration rate (eGFR) at baseline. The Kaplan–Meier curves showed that the PLR?>?137 group was significantly more likely to poor renal outcomes than the other two groups. Using univariate and multivariate cox regression analyses, we found that PLR?>?137 was an independent prognostic factor for poor renal survival in patients with IgAN. Subgroup analysis revealed that the PLR remained the prognostic value for female patients or patients with eGFR less than 60 mL/min/1.73 m².

Conclusions

Our results underscored that baseline PLR was an independent prognostic factor for poor renal survival in patients with IgAN, especially for female patients or those patients with baseline eGFR less than 60 mL/min/1.73 m².

     

Sampling‐based estimation for massive survival data with additive hazards model

For massive survival data, we propose a subsampling algorithm to efficiently approximate the estimates of regression parameters in the additive hazards model. We establish consistency and asymptotic normality of the subsample‐based estimator given the full data. The optimal subsampling probabilities are obtained via minimizing asymptotic variance of the resulting estimator. The subsample‐based procedure can largely reduce the computational cost compared with the full data method. In numerical simulations, our method has low bias and satisfactory coverage probabilities. We provide an illustrative example on the survival analysis of patients with lymphoma cancer from the Surveillance, Epidemiology, and End Results Program.     

梗死前心绞痛对初次急性心肌梗死后QTd及严重室性心律失常的影响

目的 :观察 2 4h内心绞痛发作对初次急性心肌梗死 (AMI)患者住院期间严重室性心律失常及 QT离散度 (QTd)的影响。方法 :184例初次 AMI患者 ,分为梗死前心绞痛 (PA)组 ,5 8例 ;无梗死前心绞痛 (NPA)组 ,12 6例。观察住院期间心脏并发症及 QTd。结果 :两组间一般临床情况、冠心病危险因素、AMI前用药情况、AMI后抗心律失常药物使用、溶栓成功率及入院后肌酸磷酸激酶 (CK)及其 MB亚型 (CK- MB)峰值无显著差异。PA组及 NPA组早期 QTd分别为 (5 6 .2 2± 18.40 )及 (84.45±2 1.90 ) m s,(P<0 .0 5 ) ;晚期 QTd分别为 (5 0 .6 7± 16 .34 )及 (6 4.18± 16 .41) ms(P<0 .0 5 )。PA组严重室性心律失常、心力衰竭、心源性休克发生率及院内心源性病死率明显低于 NPA组。结论 :梗死前心绞痛显著降低 AMI患者住院期间 QTd值及严重室性心律失常的发生率。提示该结果可能与缺血预适应对心肌及心室泵功能的保护及改善心室肌复极的非同步性有关     

双单抗夹心ELISA法检测脑囊尾蚴病血清特异性免疫复合物

目的 :建立双单抗夹心酶联免疫吸附试验法检测脑囊尾蚴病患者血清中特异性免疫复合物。方法 :用抗人IgG单抗包被 ,捕获血清中特异性IgG型免疫复合物 ,通过酶标抗囊尾蚴单抗结合物显色 ,测其OD值。结果 :用本方法测得患者特异性免疫复合物阳性率为 5 3.3 % ,明显高于正常对照组 (P <0 .0 0 5 ) ;循环抗原、抗体皆阴性患者 ,免疫复合物的阳性率为 5 0 % ,与各组相比差异有显著性 (P <0 .0 0 5 ) ;且免疫复合物的检出率明显高于循环抗原的检出率 (P <0 .0 0 5 )。结论 :本法对囊尾蚴病的诊断有重要的临床价值 ,尤其对抗原、抗体皆阴性患者意义更大     

粉防己碱对兔瘢痕组织作用的实验研究

目的 :研究粉防己碱对兔病理性瘢痕的组织学作用 ,为瘢痕治疗提供一种新方法。方法 :采用兔耳腹侧瘢痕模型 ,用粉防己碱 5 0mg /ml、粉防己碱 10mg /ml、去炎松 40mg /ml及生理盐水分别注入瘢痕组织 ,图像分析瘢痕组织中成纤维细胞数量和胶原含量的变化。结果 :粉防己碱治疗组瘢痕组织中成纤维细胞数量与胶原含量均明显减少 ,呈剂量效应关系 ;与生理盐水对照组比较 ,有极显著差异 (P <0 .0 1) ;与去炎松对照组比较无显著差别 (P >0 .0 5 )。结论 :粉防己碱抑制瘢痕组织中成纤维细胞增殖 ,并使胶原合成减少 ,从而抑制瘢痕组织生长 ,有望成为防治病理性瘢痕的新药物     

系统性红斑狼疮患者红细胞免疫功能的改变及与辨证分型关系的研究

目的：研究系统性红斑狼疮（SLE）患者红细胞免疫功能的变化并探讨其与中医辨证分型的关系。方法：81例患者予以狼疮活动积分,选用外周血红细胞C3b受体花环（C3bRR）率、免疫复合物花环（ICR）率、肿瘤红细胞花环（TER）率作为红细胞免疫功能的指标,常规检测血沉（ESR）、血清C3。结果：SLE患者C3bRR、TER率与健康人比较显著降低（P＜0．01）,ICR率则显著升高（P＜0．01）。C3bRR、TER率、血清C3水平依热毒炽盛、脾肾阳虚、肝肾阴虚、气阴两虚型递增,而ICR率、ESR水平依上述次序递减。结论：SLE患者红细胞免疫功能较健康人低下。C3bRR、ICR、TER率及ESR、C3水平可以作为辨证分型的辅助指标。     

利用流式细胞术研究榄香烯对肝癌腹水瘤细胞系Hca—F25／CL—1 …

采用小鼠肝癌腹水瘤细胞系Ｈｃａ－Ｆ２５／ＣＬ－１６Ａ３,利用流式细胞术研究了榄香烯对肿瘤细胞的作用,对Ｈｃａ－Ｆ２５／Ｃｌ－１６Ａ３细胞周期的影响、ＤＮＡ含量的分析以诱导细胞凋亡。结果表明：榄香烯可以明显抑制Ｈｃａ－Ｆ２５／ＣＬ－１６Ａ３细胞的增殖,有效地杀伤肿瘤细胞;榄香烯对ＣＯ／ＧＩ期细胞无明显作用,主要作用于Ｓ期,阻止由Ｓ期进入Ｇ２／Ｍ期,从而抑制肿瘤生长;可以ＧＯ／ＧＩ期前出现一个凋亡特异     

抗心磷脂抗体与系统性红斑狼疮患者病情活动性的相关性研究

为探讨系统性红斑狼疮(systemic lupus erythematosus, SLE)患者血清抗心磷脂抗体的阳性率及其与患者病情活动性关系,用酶联免疫吸附法的ACAIg含量测定药盒(ELISA)对87例SLE患者血清ACAIg含量进行了测定.结果:全组患者的 ACAIgG、A CAIgA和ACAIgM 阳性率分别为62.1%、52.9%和35.6% .ACAIgG、ACAIgM 测定值与代表SLE 活动性的病情积分呈正相关(r=0.2763,P=0.044;r=0.3294,P=0.018).AC AIgG 、ACAIgA、ACAIgM与补体C3呈负相关(r=-0.4737,P=0.000;r=-0.2990,P =0.017;r=-0.2758,P=0.029);ACAIgG与补体C4呈负相关(r=-0.40 79,P=0.005).并发血栓时,ACAIgA增高.并发狼疮脑病时,A CAIgG、ACAIgM 测定值的变化较无此并发症者明显增高.由此表明 ACA测定值的变化可以客观反映SLE患者的病情活动性.并发血栓时,ACAIgA增高.并发狼疮脑病时,ACAIgG、ACAIgM 测定值增高.     

结肠癌P糖蛋白和p53蛋白表达的关系

目的 探讨Ｐ糖蛋白（Ｐ－ｇｐ０和Ｐ５３蛋白在结肠腺癌中的表达意义。方法 应用免疫组织化学方法检测术前进行化疗的１４０例结肠癌组织中的多药耐药基因产物Ｐ－ｇｐ和Ｐ５３蛋白的表达。结果 Ｐ－ｇｐ和Ｐ５３在结肠癌中的表达为２３．５７％（３３／１４０）和４０％（５６／１４０）。Ｐ－ｇｐ表达与结肠癌的组织学类型,浸润深度和淋巴结转移状况无关（Ｐ〉０．０５）,而Ｐ５３除与淋巴结转移状况有关外（Ｐ〈０．０５）,     

中药复方962对老龄大鼠皮质胆碱乙酰转移酶和乙酰胆碱酯酶活性的影响

为研究中药复方 962胶囊对老龄大鼠皮质胆碱乙酰转移酶 (ChAT)和乙酰胆碱酯酶 (AchE)活性的影响 ,将2 2月龄和 2 4月龄Wistar大鼠分为青年对照组、老年模型组、阳性对照脑复康组 ( 0 .56g/kg)、962中剂量组 ( 0 .9g/kg)和 962大剂量组 ( 1 .8g/kg) 5组 ,分别灌胃给药 1～ 2个月后处死大鼠。用Fonnun法和羟胺比色法分别测定 5组大鼠皮质的ChAT和AchE的活性。结果 :中药复方 962大剂量 ( 1 .8g/kg)对老龄大鼠皮质ChAT活性有提高作用 (P <0 .0 5) ,但对AchE无显著影响。提示 :中药复方 962可能通过影响老龄大鼠中枢胆碱能神经系统而改善其衰老的变化