基于转录组学膀胱癌临床预后模型的构建

目的：筛选膀胱癌预后相关基因，建立膀胱癌预后评分模型。方法：通过UCSC Xena平台下载癌症基因组图谱（TCGA）数据库、基因型和基因表达量关联数据库（GTEx）中406例膀胱癌患者的临床信息和膀胱癌组织RNA测序数据，以及28名健康对照者正常膀胱组织RNA测序数据。采用加权基因共表达网络分析（WGCNA）、单因素Cox回归分析、LASSO回归分析和多因素Cox回归分析筛选膀胱癌预后相关基因并建立预后模型，结合Kaplan-Meier生存曲线、受试者操作特征曲线（ROC曲线）验证模型的准确性。结果：分析得到膀胱癌相关差异表达基因共2308个。WGCNA拟合得到6个基因模块，筛选出对膀胱癌预后有显著作用的基因829个。运用单因素Cox回归与LASSO回归分析筛选出24个与膀胱癌患者预后相关的基因，多因素Cox回归分析训练集数据得到9个作为独立预测因子的基因，分别是 ADCY9、 MAFG_DT、 EMP1、 CAST、 PCOLCE2、 LTBP1、 CSPG4、 NXPH4、 SLC1A6，以此建立膀胱癌患者预后预测模型。训练集中高风险组和低风险组3年存活率分别为31.814%和59.821%，测试集中高风险组和低风险组3年存活率分别为32.745%和68.932%，模型预测训练集和测试集患者预后的ROC曲线下面积均在0.7以上。 结论：本研究建立的模型对膀胱癌高风险和低风险人群的生存情况具有较好的预测能力。     

Supplement to the published paper "Theory-guided interventions for Chinese patients to adapt to heart failure:A quasi-experimental study"

We appreciate the question raised in a discussion with a reader and the editor about an instrument for outcome measure of the quality of life among people with ...     

益肾蠲痹法治疗系统性红斑狼疮临床报道

目的:研究益肾蠲痹法治疗系统性红斑狼疮的疗效.方法:本研究应用"益肾蠲痹法"对54例曾用激素或免疫抑制剂治疗系统性红斑狼疮,因副作用而改用益肾蠲痹法治疗3年以上的患者,观察治疗前后临床疗效、症状积分、激素剂量、血沉、C反应蛋白、ENA系列等指标变化.结果:54例系统性红斑狼疮患者治疗后的症状积分显著下降,ESR、CRP明显下降;激素用量逐渐撤减至停服,ENA系列指标阴转率最高达96.3%.结论:益肾蠲痹法对难治性系统性红斑狼疮,具有疗效高、毒副作用小、症状及实验室指标改善明显等理想疗效,是一种易于推广使用、具有良好产业化前景的治疗方法.     

四种补肾中药对去卵巢大鼠骨质疏松骨形态的作用

目的 比较骨碎补、锁阳、淫羊藿和狗脊４种补肾中药对去卵巢（ＯＶＸ）大鼠骨质疏松的作用。方法 将５４只３月龄雌性Ｗｉｓｔａｒ大鼠随机分成模型组和中药治疗组。模型组包括非手术组、假手术组和去卵巢组,每组１０只;中药组包括骨碎补组、锁阳组、淫羊藿组和狗脊组,每组６只。去卵巢手术后１周,中药组分别用上述４种中药喂养,８周后放血外死全部小鼠,用骨形态主坦学方法比较４种中药对ＯＶＸ大鼠骨质疏松的防治作用。结果     

Intimate partner violence (IPV) and preeclampsia among Peruvian women

OBJECTIVE: Mounting evidence supports the view that intimate partner violence (IPV) is an important cause of maternal mortality. Some, but not all, prior studies suggest that IPV is associated with increased risks of maternal medical conditions such as hypertensive disorders of pregnancy which are leading causes of maternal mortality worldwide. We assessed the relation between IPV and risk of preeclampsia among Peruvian women. STUDY DESIGN: We conducted a case-control study at two large hospitals in Lima, Peru. Preeclampsia cases were 339 women with pregnancy-induced hypertension and proteinuria (i.e., preeclampsia). Controls were 337 normotensive women. Information concerning women's exposure to physical and emotional violence during pregnancy was collected during in-person interviews conducted after delivery and while patients were in hospital. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from logistic regression models. RESULTS: The prevalence of IPV was 43.1% among cases and 24.3% among controls. Compared with those reporting never exposure to IPV during pregnancy, women reporting any exposure had a 2.4-fold increased risk of preeclampsia (OR=2.4; 95% CI: 1.7-3.3). The association was strengthened slightly after adjusting for maternal age, parity and pre-pregnancy adiposity (OR=2.7; 95% CI: 1.9-3.9). Emotional abuse in the absence of physical violence was associated with a 3.2-fold (95% CI: 2.1-4.9) increased risk of preeclampsia. Emotional and physical abuse during pregnancy was associated with a 1.9-fold increased risk of preeclampsia (95% CI: 1.1-3.5). CONCLUSIONS: IPV among pregnant women is common and is associated with an increased risk of preeclampsia. These data support recent calls for coordinated global health efforts to prevent violence against women.     

不同发育天数囊胚冻融移植后妊娠结局分析

目的比较不同发育天数冻融囊胚移植后的妊娠结局。方法回顾性分析1 176例行冻融囊胚移植患者的临床资料,其中植入前遗传学诊断(preimplantation genetic diagnosis,PGD)周期135例,比较第5日单囊胚移植(single embryo transfer,SET)组、双囊胚移植(double embryo transfer,DET)组与第6日SET组和DET组的妊娠结局。结果同是优质囊胚级别的条件下,第5日DET组的生化妊娠率(56.91%)、临床妊娠率(53.25%)以及多胎妊娠率(1.20%)显著高于其他组(P0.05);第5日DET组与SET组的胚胎着床率无统计学差异(P0.05),但均显著高于第6日DET组和SET组(P0.05);同级别以及PGD周期中第5日和第6日SET组相比较,第5日组的生化妊娠率、胚胎着床率均显著高于第6日组(P0.05)。结论在同是优质囊胚的条件下,第5日SET、DET及经PGD诊断的SET妊娠结局均优于第6日。     

CA153与CEA在三阴乳腺癌及非三阴乳腺癌预后中的比较分析

目的 探讨血清CA153与CEA在三阴乳腺癌及非三阴乳腺癌中表达水平的差异,并分析血清中CA153与CEA水平差异与患者预后情况的关系.方法 选取2005年1月至2012年6月经临床病理学确诊的三阴乳腺癌患者120例(三阴组)及非三阴乳腺癌患者575例(非三阴组),采用电化学发光法检测两组患者血清CA153、CEA含量,并分析这两种肿瘤标志物水平变化与患者总生存期、无进展生存期的关系.结果 三阴组患者血清CA153含量为(47.06±45.63) U/ml,明显高于非三阴组患者的(30.38±28.57) U/ml,差异有统计学意义(P＜0.01),而三阴组的CEA含量为(10.11±9.54) ng/ml,高于非三阴组的(7.03±6.87) ng/ml(P＜0.05).5年内生存分析结果表明,血清CA153＜47.06 U/ml,CEA＜10.11 ng/ml的三阴组患者和血清＜30.38 U/ml,CEA＜ 7.03 ng/ml非三阴组患者存在明显的无疾病进展时间和生存优势,差异有统计学意义(P＜0.05).结论 血清CA153与CEA可作为三阴乳腺癌及非三阴乳腺癌患者预后情况的预测指标之一.     

噻托溴铵治疗稳定期慢性阻塞性肺疾病的疗效评价

噻托溴铵是新一代治疗慢性阻塞性肺疾病(COPD)的吸入型长效抗胆碱药物,通过选择性作用于M1和M3受体,扩张支气管,疗效持续,每天只需使用一次.UPLIFT研究结果进一步证实,长期规律使用噻托溴铵能够改善中重度、极重度稳定期COPD患者肺功能情况,缓解症状、提高运动耐量及改善生活质量,延长急性发作的时间间隔、减少急性加重发作次数,降低COPD患者死亡率,具有良好的安全性.