Elevated levels of soluble fibrin in patients with venous thromboembolism

The fibrin-related markers (FRMs), including soluble fibrin (SF), d-dimer and fibrin and fibrinogen degradation products (FDP) are considered to be useful for the diagnosis of thrombosis; however, evidence for the diagnosis of thrombosis by SF is still not well established. The present study was designed to evaluate the usefulness of SF in the diagnosis of venous thromboembolism (VTE). The plasma concentrations of FRMs were measured in 551 in-patients suspected to have a VTE. The plasma levels of SF, d-dimer and FDP were significantly higher in patients with VTE than patients without VTE and those were significantly higher in patients without VTE than in healthy volunteers. In a receiver operating characteristic analysis for the diagnosis of VTE, the area under the curve was 0.950 for SF, 0.933 for FDP and 0.805 for d-dimer. The appropriate cut-off values for the diagnosis were as follows SF 5.9 μg/ml, FDP 2.1 μg/ml and d-dimer 4.8 μg/ml. To obtain a 100% negative predictive value for the diagnosis of VTE, the SF was less than 5.2 μg/ml, FDP was less than 1.3 μg/ml, and d-dimer was less than 0.5 μg/ml. Our findings suggest that the SF assay is useful for the diagnosis and exclusion of VTE.     

TYMS-TM4SF4 axis promotes the progression of colorectal cancer by EMT and upregulating stem cell marker

Background: The expression of thymidylate synthase (TYMS) is significantly up-regulated in various cancers and associated with the poor prognosis of patients. However, the role of TYMS in the progression of colorectal cancer (CRC) is unclear. Methods: Cell function assay, biology information analysis, and RNA sequencing were used to investigate the role of TYMS in the progression of CRC and underlining molecular mechanism. SPSS22.0 statistical software and GraphPad Prism 5 (Graphpad software) were used for statistical analysis. Results: Our results showed that TYMS expression was higher in CRC tissues than that in non-tumor colorectal mucosa tissues. TYMS knockdown inhibited the proliferation, migration and invasion of HCT116 and HT29 cells, and the spheroid formation of HCT116 cells. The underling mechanism demonstrated that TYMS promoted the progression of CRC by regulating EMT-related proteins including E-cadherin, Vimentin, MMP-9 and stem cell biomarkers including CD133 and CD44. Furthermore, DEG sequencing showed that TYMS knockdown enriched the pathways of metastasis and metabolism by GO and KEGG analysis. We identified TM4SF4 was the downstream target of TYMS in CRC cells. TM4SF4 overexpression increased migration and invasion of CRC cells by regulating EMT and CD133 expression. Conclusions: Our findings suggest that TYMS-TM4SF4 axis may promote the progression of CRC by EMT and upregulating stem cell markers.     

Effect of long‐term late‐evening snack on health‐related quality of life in cirrhotic patients

Aim: In patients with liver cirrhosis, abnormal energy metabolism induces low health‐related quality of life (HRQOL) scores. However, late‐evening snack (LES) prevents morning starvation in cirrhotic patients. Our aim is to assess the effect of long‐term LES on HRQOL in cirrhotic patients, using the 36‐item Short Form (SF‐36) health survey. Methods: Thirty‐nine cirrhotic patients classified as Child–Pugh grade A were recruited. The patients were randomly divided into two groups: 24 were assigned to the non‐LES group and 15 to the LES group. SF‐36 scores, anthropometric data and serum biochemical parameters were examined in the non‐LES and LES groups at 0, 6 and 12 months. Results: Neither anthropometric data nor laboratory data showed significant differences between the non‐LES and the LES groups at 0, 6 and 12 months. The role–emotional (RE) HRQOL scores at 6 months and mental health (MH) scores at 6 and 12 months were significantly reduced from the baseline level in the non‐LES group. In contrast, these scores remained unchanged in the LES group. General health perception (GH) scores at 12 months, RE at 6 months and MH at 6 and 12 months in the LES group were significantly higher than those of the non‐LES group. Conclusion: Long‐term LES administration may be helpful in maintaining higher HRQOL in patients with cirrhosis.     

四项肿瘤标志物联合检测对胰腺癌的诊断价值

本文对21例胰腺癌患者及56例良性消化系疾患者测定癌抗原19-9（CA19-9）和癌抗原50（CA50），铁蛋白（SF）及癌胚抗原（CEA），发现胰腺癌组四项指标的血浓度及检出率均高于对照组，具有统计学差异（iP/i0.01），其中以CA19-9敏感性最高，为76.19%，其次为CA50，二者均具较高的特异性及临床符合率。选择CA19-9与其他肿瘤标志物联合检测，显示CA19-9+CA50或SF，阳性率为85.71%，但与各单项标志物比较无明显差异，全部四项标志物同时检测，临床敏感性达100%，与各单指标比较差异显著，但特异性有所降低。结果表明，CA19-9和CA50为胰腺癌诊断较为理想的标志物，若两者联合或与SF及CEA组合检测，对提高胰腺癌诊断的敏感性，用于可疑患者的筛查具有较好的应用价值。     

肿瘤标志物测定在卵巢肿瘤诊断中的价值

目的:探讨肿瘤标志物在印巢肿瘤诊断中的价值。方法:随机抽取1999年1月-2002年12月我院收治的卵巢肿瘤患者105例,根据病理分类进行分组,回顾性分析其血清 AFP、CEA、血清铁蛋白(SF)、CA125、CA19-9、CA15-3水平,利用 SAS 统计分析系统分别评价其在卵巢肿瘤诊断中的价值。结果:①卵巢癌患者血清中 CA125、CA15-3、SF 含量明显高于良性肿瘤患者(P<0.01).恶性组 CA19-9含量明显高于良性组(P<0.05).AFP 和 CEA 含量在两组之间差异无显著性(P>0.05);②单项指标以 CA125的诊断性能最好,其次为 CA15-3、CA19-9、SF;③Ⅲ～Ⅳ期卵巢癌患者血清中 CA125、CA15-3、SF 含量及阳性率均高于Ⅰ～Ⅱ期卵巢癌患者(P<0.01),CA19-9在两组患者中差异无显著性(P>0.05);④上皮性卵巢癌患者血清中 CA125的阳性率高于非上皮性印巢癌患者,差异具显著性(P<0.05),其余差异无显著性(P>0,05);⑤指标联合检测时,在全部不同指标组合中,以 CA125、CA15-3、CA19-9、SF 4项中任意2项阳性作为卵巢恶性肿瘤的判断有较好的诊断性能;在3项指标联合检测中,以 CA125、CA19-9、SF 指标组合诊断性能最好。结论:CA125、CA15-3、CA19-9和 SF 可以作为卵巢良恶性肿瘤的鉴别和恶性肿瘤预后判断的指标。     

Vagus nerve stimulation has a positive effect on mood in patients with refractory epilepsy

Background

Preliminary research on the efficacy of vagus nerve stimulation (VNS) indicated additional effects on neuropsychological variables like mood and quality of life (QOL).

Objectives

The objectives of this prospective longitudinal observational cohort study were to assess the effects of VNS on mood, QOL and cognition in patients with refractory epilepsy and to determine whether these effects occur dependent of seizure control.

Methods

We included 41 patients with refractory epilepsy; treated with VNS as part of usual patient care. A neuropsychological battery was performed during baseline and repeated after 6 months of VNS in order to compare neuropsychological variables before and after VNS. All patients completed seizure diaries.

Results

Significant improvements were observed for both mood and QOL after 6 months of VNS; based on the results in the POMS and QOLIE-89 questionnaires (p < 0.05). There was no significant change in cognition. Mean percentage change in seizure frequency was −9.0%, while 20% of the patients achieved a seizure frequency reduction of 50% or more. No significant correlation was found between changes in seizure frequency and improvements in mood or QOL.

Conclusions

VNS is associated with improvements in both mood and QOL in patients with refractory epilepsy. Since these improvements appeared to be independent of seizure control, the results of this study indicate an additional antidepressant effect of VNS, which can be of extra value in view of the high co-morbidity of mood disturbances in patients with epilepsy.