Diagnostic value of periostin in lung cancer‐related malignant pleural effusion

BackgroundPeriostin (POSTN) is an extracellular matrix protein that is overexpressed in lung cancer and is considered an effective diagnostic and prognostic biomarker for lung cancer. The purpose of this study was to investigate the diagnostic performance of POSTN and to further evaluate the diagnostic value of POSTN combined with carcinoembryonic antigen (CEA) and cancer ratio [CR: serum lactate dehydrogenase (LDH)/pleural effusion adenosine deaminase (PE ADA)] in lung cancer‐related malignant PE (MPE).MethodsA total of 108 patients with PE, including 54 with lung cancer and 54 with benign lung disease, were enrolled in this study. The POSTN levels of PE and serum were detected using an enzyme‐linked immunosorbent assay. Information on the expression of PE and serum CEA, serum LDH, and PE ADA was collected from medical records.ResultsThe levels of PE POSTN in MPE of patients with lung cancer were significantly higher than those in patients with benign PE (p < 0.0001). The receiver operating characteristic (ROC) curve indicated that the diagnostic sensitivity and specificity of PE POSTN for lung cancer‐related MPE were respectively 77.78% and 68.52% when the cutoff value was determined to be 53.45 ng/ml. The ROC curve analysis demonstrated that PE POSTN has a high diagnostic value in MPE associated with lung cancer [area under the curve (AUC) = 0.764], and the combination of PE POSTN, PE CEA, and CR can improve the diagnostic accuracy of lung cancer‐related MPE (AUC = 0.948).ConclusionPOSTN can be used as a potential marker for lung cancer‐related MPE diagnosis.     

Effect of Continuous Ingestion of 2 g of Medium-Chain Triglycerides on Substrate Metabolism during Low-Intensity Physical Activity

Increasing fat burning during physical activity is thought to be an effective strategy for maintaining health and preventing lifestyle-related diseases, such as obesity and diabetes. In recent years, medium-chain triglycerides (MCTs) have gained attention as a dietary component for increasing fat-burning. However, this fat-burning effect has been unclear in people with high body mass index (BMI). Therefore, we aimed to clarify the effects of 2 g of daily ingestion of MCTs over 2 weeks on substrate oxidation during low-intensity physical activity in sedentary (i.e., with no exercise habit) subjects with a BMI from 25 (kg/m²) to less than 30, which is classified as obese in Japan. A placebo-controlled, randomized, double-blind, crossover study with a 2-week washout period was conducted. The rate of fat oxidation as well as the respiratory exchange ratio (RER) during exercise (with a cycle ergometer at a 20-watt load) were measured with a human calorimeter. MCTs ingestion significantly increased fat oxidation during physical activity and decreased RER compared to long-chain triglycerides ingestion. In conclusion, we suggest that daily ingestion of 2 g of MCTs for 2 weeks increases fat burning during daily physical activities in sedentary persons with a BMI ranging from 25 to less than 30.     

尿酸水平与传染性单核细胞增多症关系的研究

目的:探讨尿酸水平与传染性单核细胞增多症(IM)之间的关系.方法:本研究入组95例IM患者(男性47例、女性48例)和95名健康对照者,临床资料按性别分类.采用受试者工作特征(ROC)曲线分析法确定预测发生IM的尿酸切点值,用二元Logistic回归计算风险比(OR).结果:IM患者的尿酸水平明显低于对照组,男性尿酸水...     

Combined tumor plus nontumor interim FDG-PET parameters are prognostic for response to chemoradiation in squamous cell esophageal cancer

We have investigated the prognostic value of two novel interim ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) parameters in patients undergoing chemoradiation (CRT) for esophageal squamous cell carcinoma (ESCC): one tumor parameter (maximal standardized uptake ratio rSUR) and one normal tissue parameter (change of FDG uptake within irradiated nontumor-affected esophagus ∆SUV_NTO). PET data of 134 European and Chinese patients were analyzed. Parameter establishment was based on 36 patients undergoing preoperative CRT plus surgery, validation was performed in 98 patients receiving definitive CRT. Patients received PET imaging prior and during fourth week of CRT. Clinical parameters, baseline PET parameters, and interim PET parameters (rSUR and ∆SUV_NTO) were analyzed and compared to event-free survival (EFS), overall survival (OS), loco-regional control (LRC) and freedom from distant metastases (FFDM). Combining rSUR and ∆SUV_NTO revealed a strong prognostic impact on EFS, OS, LRC and FFDM in patients undergoing preoperative CRT. In the definitive CRT cohort, univariate analysis with respect to EFS revealed several staging plus both previously established interim PET parameters as significant prognostic factors. Multivariate analyses revealed only rSUR and ∆SUV_NTO as independent prognostic factors (p = 0.003, p = 0.008). Combination of these parameters with the cutoff established in preoperative CRT revealed excellent discrimination of patients with a long or short EFS (73% vs. 17% at 2 years, respectively) and significantly discriminated all other endpoints (OS, p < 0.001; LRC, p < 0.001; FFDM, p = 0.02), even in subgroups. Combined use of interim FDG-PET derived parameters ∆SUV_NTO and rSUR seems to have predictive potential, allowing to select responders for definitive CRT and omission of surgery.     

Risk stratification in breast cancer screening: Cost-effectiveness and harm-benefit ratios for low-risk and high-risk women

In mammography screening programmes, women are screened according to a one-size-fits-all principle. Tailored screening, based on risk levels, may lead to a better balance of benefits and harms. With microsimulation modelling, we determined optimal mammography screening strategies for women at lower (relative risk [RR] 0.75) and higher (RR 1.8) than average risk of breast cancer, eligible for screening, using the incremental cost-effectiveness ratio (ICER) of current uniform screening in the Netherlands (biennial [B] 50-74) as a threshold ICER. Strategies varied by interval (annual [A], biennial, triennial [T]) and age range. The number of life-years gained (LYG), breast cancer deaths averted, overdiagnosed cases, false-positive mammograms, ICERs and harm-benefit ratios were calculated. Optimal risk-based screening scenarios, below the threshold ICER of €8883/LYG, were T50-71 (€7840/LYG) for low-risk and B40-74 (€6062/LYG) for high-risk women. T50-71 screening in low-risk women resulted in a 33% reduction in false-positive findings, a similar reduction in costs and improved harm-benefit ratios compared to the current screening schedule. B40-74 in high-risk women led to an increase in screening benefit, compared to current B50-74 screening, but a relatively higher increase in false-positive findings. In conclusion, optimal screening consisted of a longer interval and lower stopping age than current uniform screening for low-risk women, and a lower starting age for high-risk women. Extending the interval for women at lower risk from biennial to triennial screening reduced harms and costs while maintaining most of the screening benefit.     

Relationship between pediatric adiposity and cardiovascular risk factors in Saudi children and adolescents

BackgroundThe etiology of childhood obesity is growing at alarming rates in developed and developing countries. The aim of the present study was to investigate the prevalence of cardiovascular risk factors (hypertension, dyslipidemia, and hyperglycemia) in a sample of Saudi children and to assess their association with different measures of body adiposity.MethodsA cross-sectional study was conducted of 200 Saudi children, who were randomly selected from the pediatric clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Anthropometric variables were measured for all study subjects. Fasting blood samples were collected for measurement of blood glucose, insulin, and lipid profile.ResultsAlmost half of the study population was overweight and one tenth was obese according to body mass index levels, irrespective of sex. The prevalence of central obesity was higher using the waist-height ratio as opposed to waist circumference and this was true for both sexes. Significantly higher means levels of glucose, insulin, and lipids (P < 0.0001 in all) were seen among overweight and obese children than their lean counterparts. All obesity measures in children were significantly associated with cardiovascular risk factors.ConclusionThe severity of overall and abdominal obesity in Saudi children is associated with a higher prevalence of cardiovascular risk factors, with the relationship strength varying by sex.     

髓/囊比值对儿童复杂脊髓脂肪瘤手术后再拴系的影响

目的探讨髓/囊比值对儿童复杂脊髓脂肪瘤手术后远期再拴系的影响。方法回顾性分析2009年1月至2014年6月深圳市儿童医院神经外科采用手术治疗的复杂脊髓脂肪瘤患儿的临床资料,共56例。采用神经电生理监测下显微手术切除脂肪瘤+重塑神经基板+硬膜囊成型的方法。术后应用MRI评估髓/囊比值,分析髓/囊比值对术后远期脊髓再拴系的影响。结果56例患儿均顺利完成手术。术后MRI显示髓/囊比值<30%者10例,30%~50%者31例,>50%者15例。患儿均未发生术后严重并发症。术后中位随访时间为8.9年(5.0~10.5年),失访4例。6例(11.5%,6/52)发生脊髓再拴系需要再次行手术治疗(再拴系组),其中术后髓/囊比值为30%~50%者2例,>50%者4例。无再拴系组的46例患儿髓/囊比值<30%10例,30%~50%27例,>50%9例。两组髓/囊比值差异有统计学意义(P=0.039)。结论髓/囊比值是影响儿童复杂脊髓脂肪瘤术后再拴系的重要因素,髓/囊比值越小,再拴系的概率越小。     

中性粒细胞-淋巴细胞比值在颅脑损伤预后评估中的作用

目的 探讨中性粒细胞-淋巴细胞比值（NLR）在颅脑损伤（TBI）预后评估中的作用。方法 回顾性分析2015年3月~2019年1月收治的105例TBI的临床资料。伤后6个月,采用GOS评分评估预后,1~3分为预后不良,4~5分为预后良好。采用多因素logistic回归分析检验预后不良危险因素,采用受试者工作特征（ROC）曲线分析NLR对TBI病人6个月预后的预判价值。结果 105例中,预后不良34例,发生率为32.38%。多因素logistic回归分析结果显示,入院时GCS评分≤8分、颅内压增高、瞳孔对光反射消失和NLR均是TBI病人伤后6个月预后不良的独立危险因素（P<0.05）。ROC曲线分析结果显示NLR的最佳临界值为4.12,此时灵敏度为85.7%,特异度为81.6%,当NLR≥4.12时,TBI病人预后不良的发生率高达93.6%。结论 入院时NLR水平可作为预测TBI伤后6个月预后不良的参考指标,可早期、迅速、准确判断病人预后,及时有效地采取干预措施,改善病人预后