COL5A2 as a potential clinical biomarker for gastric cancer and renal metastasis

Background:Gastric cancer, characterized by insidious onset and multiple metastasis, is almost incurable and has poor prognosis, and also one of the leading causes of treatment failure and death in patients with gastric cancer (GC). However, the prognosis of collagen type V alpha2 chain (COL5A2) in GC and renal metastasis is unknown.Methods:Recruited 148 patients who underwent GC. The diagnosis of GC was confirmed by ultrasound imaging and pathological examination. Immunohistochemistry and RT-qPCR were performed to exam the expression level of COL5A2. The statistical methods included Pearson chi-square test, Spearman-rho correlation test, univariate and multivariate cox regression analysis. Finally, this research constructed receiver operating characteristic (ROC) curves and applied the area under the curve (AUC).Results:Based on Pearson''s chi-square test, Spearman-rho test, and univariate/multivariate cox regression, pathologic grade (P < .001), renal metastasis (P < .001) and staging (P < .001) were significantly related to COL5A2. And COL5A2 expression (hazard ratio [HR]: 18.834, P < .001) is an independent risk factor of GC. The AUC was used as the degree of confidence in judging each factor: COL5A2 (AUC = 0.878, P < .001), COL1A1 (AUC = 0.636, P = .006), COL1A2 (AUC = 0.545, P = .368), and COL3A1 (AUC = 0.617, P = .019). Through the ROC result, COL5A2 had more advantage as a biomarker for GC than other collagens.Conclusions:COL5A2 gene expression level might be a risk factor for GC. COL5A2 has a strong correlation with the prognosis of the disease.     

根治性前列腺癌病理分期及pT2病理亚分期的意义

目的探讨根治性前列腺癌病理分期及p T2病理亚分期的意义。方法回顾性分析根治性前列腺癌30例,观察肿瘤累及范围、前列腺外及精囊腺侵犯情况,依据2002/2010年TNM分期系统对其行病理分期。结果 30例术前临床评估为局限性前列腺癌,前列腺癌根治术后病理分期:p T2期15例,p T3a期10例,p T3b期5例。p T2期肿瘤中2例为p T2a,13例为p T2c,占p T2期肿瘤的86.7%,无p T2b期肿瘤。结论根治性前列腺癌术后病理分期更加直观和准确,更能够反映肿瘤真实的状态,对预后的评估更有价值,而2002/2010年TNM分期系统对于p T2期肿瘤的亚分期,仅依据肿瘤累及腺叶的范围划分并不完善,需进一步加以改善。     

地方性氟中毒病区中氟对胎儿影响的研究

本文以不同氟水平地区153名怀孕4个月以上的孕妇为对象研究氟对胎儿可能产生的影响。结果表明,随着孕妇尿氟水平的升高其胎儿羊水氟含量也升高,差异显著(p<0.01)。通过对29例胎儿股骨的光镜观察及3例扫描电镜的观察,发现孕妇尿氟、胎儿羊水氟水平高者有明显病理改变,主要表现为骨生成活跃且紊乱。病理改变与尿氟、羊水氟氟水平有关,当尿氟小于2.0mg/L、羊水氟小于0.03mg/L 无病理改变发生。尿氟水平低于3.5mg/L 组,病理改变率为17.39%,(4/23),高于7mg/L 组病理改变率为83.33%(5/6),两者差异显著(P=0.0055);羊水氟水平低于0.05mg/L 组病理改变率为8.3%(1/12),高于0.05mg/L 组为47.06(8/17),差异显著(p=0.0422)。研究结果提示,氟能经过胎盘进入胎儿体内且可用羊水氟水平反应胎儿受氟量的高低及判断能否受到影响,说明氟对人体的作用在胎儿时期即可发生,这为氟中毒的早期防治提供了依据。     

T-level downstaging and complete pathologic response after preoperative chemoradiation for advanced rectal cancer result in decreased recurrence and improved disease-free survival

PURPOSE: Preoperative chemoradiation therapy is used widely in the treatment of rectal cancer. The predictive value of response to neoadjuvant remains uncertain. We retrospectively evaluated the impact of response to preoperative and, specifically, of T-level downstaging, nodal downstaging, and complete pathologic response after chemoradiation therapy on oncologic outcome of patients with locally advanced rectal cancer. METHODS: There were 88 patients with ultrasound Stage T3/T4 midrectal (n = 37) and low rectal (n = 51) cancers (63 males; mean age 62.6 years). All patients were treated by preoperative 5-fluorouracil-based chemotherapy and pelvic radiation followed by surgical resection in six weeks or longer (56 sphincter-preserving resections). RESULTS: T-level downstaging after neoadjuvant treatment was demonstrated in 36 (41 percent) of 88 patients, and complete pathologic response was observed in 16 (18 percent) of the 88. Of the 42 patients with ultrasound-positive nodes, 27 had no evidence of nodal involvement on pathologic evaluation (64 percent). The overall response rate (T-level downstaging or nodal downstaging) was 51 percent. At a median follow-up of 33 months, 86.4 percent of patients were alive. The overall recurrence rate was 10.2 percent (three patients had local and six had metastatic recurrences). Patients with T-level downstaging and complete pathologic response were characterized by significantly better disease-free survival (P = 0.03, P = 0.04) and better overall survival (P = 0.07, P = 0.08), according to Wilcoxons test comparing Kaplan-Meier survival curves. None of the patients with complete pathologic response developed recurrence or died during the follow-up period. CONCLUSION: T-level downstaging and complete pathologic response after preoperative chemoradiation therapy followed by definitive surgical resection for advanced rectal cancer resulted in decreased recurrence and improved disease-free survival. Advanced rectal cancers that undergo T-level downstaging and complete pathologic response after chemoradiation therapy may represent subgroups that are characterized by better biologic behavior.     

强化护理健康教育对行准分子激光上皮瓣下角膜磨镶术近视患者的效果分析

[摘要]目的 分析强化护理健康教育对接受准分子激光上皮瓣下角膜磨镶术的近视患者的术后用药依从性和视觉满意度的影响。方法 选择2015年3月-2015年9月在我院45例接受常规健康教育的行准分子激光上皮瓣下角膜磨镶术近视患者,将其作为对照组;再选取2015年10月-2016年3月接受强化护理健康教育的行准分子激光上皮瓣下角膜磨镶术近视患者作为观察组。对比两组患者术后用药的依从性情况,同时比较两组患者术后的视觉满意度。结果 观察组患者的用药依从率为91.1%,对照组患者的用药依从率为68.9%,差异有统计学意义(P＜0.05)。观察组患者的视觉满意度为100.0%,对照组患者的视觉满意度为84.4%,差异有统计学意义(P＜0.05)。结论 强化护理健康教育应用于行准分子激光上皮瓣下角膜磨镶术的近视患者中,能够提高患者的用药依从性,增强患者的视觉满意度,值得临床进一步推广应用。     

高度近视黄斑裂孔性视网膜脱离应用玻璃体切除联合硅油填充的手术效果分析

[摘要]　目的　探讨玻璃体切除联合硅油填充治疗高度近视黄斑裂孔性视网膜病变脱离(MHRD)的适应证及治疗效果。　方法　选择29例（29只眼）高度近视黄斑裂孔性视网膜脱离患者,同时伴有视网膜周边裂孔,行玻璃体切除联合硅油填充及内界膜撕除。术后保持头低位3周,随访6～12个月,其中硅油填充时间3～6个月。观察患眼手术后矫正视力、视网膜复位、黄斑裂孔闭合情况以及并发症。　结果　　手术后29只眼视网膜完全复位,复位率为100%。视网膜脱离复发1只眼,占3.47％。黄斑裂孔复位闭合11只眼（37.9％）;术后视力提高者26例26只眼（89.7％）,不变者3只眼（10.3％）;术后2周,出现高眼压 4只眼,占13.8％,给予降低眼压药物治疗后眼压控制。硅油取出手术前出现高眼压 2只眼（6.89％）,硅油取出手术后眼压均得到控制。　结论　玻璃体切割联合内界膜撕除及硅油填充可在伴有视网膜周边裂孔高度近视黄斑裂孔性视网膜病变脱离患者中获得较高的手术复位率。     

重视高度近视合并闭角型青光眼

目前,国内外不同人种、不同地区的流行病学调查和临床研究均显示近视(尤其是高度近视)是青光眼独立于眼压之外的危险因素.虽然开角型青光眼是高度近视合并青光眼的主要类型,但是近些年却不断有高度近视合并闭角型青光眼的报道.本文对高度近视合并青光眼的类型以及高度近视合并闭角型青光眼的发病机制进行讨论分析,目的是提醒眼科医师在临床工作中重视高度近视合并闭角型青光眼,以免误诊漏诊.