The expression of vascular endothelial growth factor (VEGF)/ endostatin (ES) and VEGF receptor 2 (VEGFR2)/ES is associated with NSCLC prognosis

Objective The aim of our study was to detect the expression of angiogenesis inhibitory proteins and angiogenesis promotive proteins in the postoperative tumor tissue of non-small cell lung cancer (NSCLC) patients. We also investigated the relationship of protein expression with clinical characteristics and prognosis. Methods We examined the expression of vascular endothelial growth factor (VEGF), VEGF receptor 2 (VEGFR2), and endostatin (ES) proteins in 255 specimens resected from NSCLC patients, using immune histochemistry (IHC). We then evaluated the relationships between the expression of the three proteins and clinical characteristics such as stage, histological type, differentiation, gender, tobacco use, and age. According to the value of VEGF/ES, we divided the cohort into angiogenesis-promoting group A, angiogenesis-inhibiting group A, and balance group A. The survival differences in the three groups were evaluated to determine the prognostic value of VEGF/ES. Similarly, we tested the prognostic value of VEGFR2/ES. Results VEGF-positive expression was observed in 93 patients (36.4％). VEGF expression was not correlated with the clinical characteristics. VEGFR2-positive expression was observed in 103 patients (40.4％). The expression of VEGFR2 was correlated with the clinical stage (χ2 = 21.414, P = 0.045) and histological type (χ2 = 26.911, P = 0.008). ES-positive expression was observed in 140 patients (54.9％). The expression of ES was correlated with the clinical stage (χ2 = 26.504, P = 0.009). When evaluating the prognostic values of VEGF/ES and VEGFR2/ES, the prognosis of the angiogenesis balance group was similar to that of the angiogenesis-inhibiting group. The minimum survival time was observed in the angiogenesis-promoting group. Conclusion VEGF/ES and VEGFR2/ES in resected tumors have prognostic value in postoperative NSCLC patients. The survival time of the population with predominant angiogenic factors was short.     

Hypoxia-induced lncRNA CASC9 enhances glycolysis and the epithelial-mesenchymal transition of pancreatic cancer by a positive feedback loop with AKT/HIF-1α signaling

Increasing evidence indicates the dysregulations and pivotal roles of lncRNAs in the development and progression of various cancers, including pancreatic cancer. Enhanced glycolytic flux and epithelial-to-mesenchymal transition (EMT) have been considered as important factors in driving the malignance of pancreatic cancer. Here, we sought to evaluate the biological role and involved mechanism of lncRNA CASC9 (CASC9) in pancreatic cancer. Our present study showed that CASC9 was upregulated in various pancreatic cancer cell lines. Loss- and gain-of function of CASC9 demonstrated its critical roles in promoting the glycolysis and EMT phenotypes of pancreatic cancer. Moreover, knockdown of CASC9 inhibited the tumorigenicity and metastasis in vivo. Additionally, our findings showed that hypoxia induced the expression of CASC9 and enhanced the binding of HIF-1α to its promoter. We also demonstrated that the positive feedback loop of CASC9 and the AKT/HIF-1α signaling cascade partially mediated this biological process. Altogether, our results suggest that CASC9 promotes the glycolysis and EMT of pancreatic cancer by a positive feedback loop with AKT/HIF-1α signaling, which is synergistically enhanced by the tumor hypoxic niche. Our study will provide potential therapeutic targets for treating pancreatic cancer.     

嵌合抗原受体T细胞治疗安全性研究进展

嵌合抗原受体T细胞(CAR-T)治疗进展迅速,其安全性问题一直受到广泛关注。第62届美国血液学会年会上针对其主要不良反应的发生机制、预测指标及治疗策略进行了一系列报道,对全面提高CAR-T治疗的安全性具有一定的指导意义。     

Esthetic comparison of white-spot lesion treatment modalities using spectrometry and fluorescence

Objective:To compare the esthetic improvements of white-spot lesions (WSLs) treated by fluoride, casein phosphopeptide amorphous calcium phosphate (CPP-ACP), or resin infiltration.Materials and Methods:WSLs were created on human enamel and randomly assigned to four groups: NaF (500 ppm), CPP-ACP, resin infiltration (Icon), or distilled deionized water (DDW; control group). The color change (ΔE) of each specimen was measured with a Crystaleye spectrophotometer, and fluorescence loss (ΔQ) was measured by quantitative light-induced fluorescence (QLF), at different time points after treatment: baseline (0 weeks), 2 weeks, 4 weeks, and 6 weeks.Results:The ΔE and ΔQ baseline values for the four groups before the treatments did not differ significantly. Icon treatment improved the WSL color significantly and gave the lowest ΔE (2.9 ± 1.2 on average) compared with other treatments (P < .01). The Icon treatment also resulted in a significant change in the ΔQ of WSLs compared with baseline (P < .01). In the NaF and CPP-ACP treatment groups, ΔQ showed significant recovery compared with the baseline values only after 4 weeks after treatment (P < .05).Conclusions:Resin infiltration is more effective than NaF or CPP-ACP in providing esthetic improvement of WSLs.     

血清PCT对危重新生儿应用抗菌药物的指导价值

目的探讨血清降钙素原(PCT)对危重新生儿应用抗菌药物的价值,以指导临床合理使用抗菌药物。方法纳入186例住院危重新生儿,其中,未应用抗菌药物的124例新生儿作为对照组,应用抗菌药物的62例新生儿为观察组。对比分析患儿住院时的体温状况和住院后的PCT、白细胞计数(WBC)、C-反应蛋白(CRP)和红细胞沉降率(ESR),并记录入选患儿预后状况。记录观察组患儿使用抗菌药物当天的PCT、WBC、CRP、体温,以及用药3 d后的PCT水平和体温状况。结果观察组患儿医院感染部位分布情况:肠道感染28例,占45.2%;上呼吸道感染17例,占27.4%;下呼吸道感染9例,占14.5%;泌尿道感染4例,占6.5%。两组患儿入院时的年龄、性别、体温、PCT、WBC、CRP、ESR和治愈例数[观察组:61例(98.39%),对照组121例(97.58%)]比较差异无统计学意义(P>0.05)。两组患儿预后情况比较差异无统计学意义(P>0.05),但观察组患儿的住院时间比对照组长(P<0.01)。观察组患儿在抗菌药物使用当日,PCT高于入院时(P<0.05),体温、WBC、CRP水平无显著变化(P>0.05);使用抗菌药物3 d后,患儿PCT比用药当日显著降低(P<0.05),体温比入院时和用药当日显著降低(P<0.05)。结论通过监测PCT可以指导危重新生儿的抗菌药物应用。     

大鼠骨髓基质干细胞在成骨诱导剂条件下的成骨能力

目的:观察在有成骨诱导剂存在的条件下,大鼠骨髓基质干细胞向成骨细胞转化的能力。方法:实验于2005-07/12在锦州医学院中心实验室完成。选取清洁级2月龄SD大鼠6只,无菌条件下取双侧股骨,制备单细胞悬液。采用贴壁培养与传代结合方法分离纯化大鼠骨髓基质干细胞,将2代细胞置于含有1×10-7mol/L地塞米松、10mol/Lβ-甘油磷酸钠、50mg/L抗坏血酸成骨诱导剂的培养基中,培养21～30d。应用倒置显微镜观察骨髓基质干细胞与诱导后细胞形态,描绘生长曲线,流式细胞仪检测细胞周期,并用碱性磷酸酶染色和VON-KOSSA法检测成骨能力。结果:6只大鼠均进入结果分析。①骨髓基质干细胞形态学观察结果:在成骨诱导剂里细胞增殖变缓慢,呈长梭形、成纤维细胞样或不规则形。②细胞生长曲线:1～2d为潜伏期,细胞增殖不明显;3d后细胞增殖明显加快,进入对数生长期;6d后增殖变慢为平台期。经计算细胞群体倍增时间为38h。③细胞增殖周期检测结果:G0/G1期为(82.12±4.60)%,S期为(14.35±2.32)%,G2/M期为(0.87±0.30)%。④成骨能力检测结果:细胞碱性磷酸酶染色阳性率为86%,VON-KOSSA染色提示有钙结节形成。结论:大鼠骨髓基质干细胞在有成骨诱导剂存在的情况下成骨能力较高。     

护士长任期目标责任制考核模式的相关研究

目的:建立竞争机制,破除“护士长终身制”,实现以“优胜劣汰”为原则的能级管理。方法:制定考核指标及权重,确定考核形式及周期。结果:通过3次考核的实施,逐步建立并完善护士长任期目标责任考核模式。结论:经实践证明,此考核模式比较实用, 具有公正、公平、公开的优点。     

Performance of Fasting Plasma Glucose and Postprandial Urine Glucose in Screening for Diabetes in Chinese High-risk Population

Background:

The conventional approaches to diabetes screening are potentially limited by poor compliance and laboratory demand. This study aimed to evaluate the performance of fasting plasma glucose (FPG) and postprandial urine glucose (PUG) in screening for diabetes in Chinese high-risk population.

Methods:

Nine hundred and nine subjects with high-risk factors of diabetes underwent oral glucose tolerance test after an overnight fast. FPG, hemoglobin A1c, 2-h plasma glucose (2 h-PG), and 2 h-PUG were evaluated. Diabetes and prediabetes were defined by the American Diabetes Association criteria. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of 2 h-PUG, and the optimal cut-off determined to provide the largest Youden index. Spearman correlation was used for relationship analysis.

Results:

Among 909 subjects, 33.4% (304/909) of subjects had prediabetes, and 17.2% (156/909) had diabetes. The 2 h-PUG was positively related to FPG and 2 h-PG (r = 0.428 and 0.551, respectively, both P < 0.001). For estimation of 2 h-PG ≥ 7.8 mmol/L and 2 h-PG ≥ 11.1 mmol/L using 2 h-PUG, the area under the ROC curve were 0.772 (95% confidence interval [CI ]: 0.738–0.806) and 0.885 (95% CI: 0.850–0.921), respectively. The corresponding optimal cut-offs for 2 h-PUG were 5.6 mmol/L and 7.5 mmol/L, respectively. Compared with FPG alone, FPG combined with 2 h-PUG had a higher sensitivity for detecting glucose abnormalities (84.1% vs. 73.7%, P < 0.001) and diabetes (82.7% vs. 48.1%, P < 0.001).

Conclusion:

FPG combined with 2 h-PUG substantially improves the sensitivity in detecting prediabetes and diabetes relative to FPG alone, and may represent an efficient layperson-oriented diabetes screening method.     

慢性疼痛患者生活质量及其相关因素分析

目的:了解慢性疼痛患者的生活质量状况,并分析其相关影响因素。方法:选取就诊于解放军总医院疼痛科门诊慢性疼痛患者为研究对象,研究工具包括一般资料调查表、简式Mc Gill疼痛问卷(short-form of Mc Gill pain questionnaire,SF-MPQ)及生活质量指数(quality of life index,QL-Index)。结果:1慢性疼痛患者生活质量总分与SF-MPQ总分、感觉项总分、情感项总分、视觉模拟评分(visual analogue scale,VAS)、现时疼痛强度(present pain intensity,PPI)、感觉项计数、情感项计数均呈显著负相关(r=-0.195~-0.433));2多元线性逐步回归分析模型可解释慢性疼痛患者生活质量指数改变的88.8%,情感项总分、感觉项总分、VAS评分、感觉项计数、情感项计数、PPI评分对患者生活质量改变有影响,尤其以目前疼痛强度评分对患者生活质量的影响最为显著。结论:慢性疼痛患者的生活质量受其疼痛特征的多重影响,患者目前疼痛强度对其生活质量的影响最为显著。