miRNA-21-5P在食管鳞癌患者中的鉴别诊断价值

目的检测食管癌患者血清miRNA-21-5P的表达水平,探讨miRNA-21-5P对食管癌患者的鉴别诊断价值。方法选取2019年12月至2020年3月于朝阳市中心医院就诊的食管鳞癌患者50名(疾病组)及食管炎患者20名(相关疾病对照组),采集食管炎患者血清样本及组织样本,以及食管鳞癌患者治疗前血清样本、术中食管鳞癌组织及癌旁组织。通过实时荧光定量PCR(qRT-PCR)检测2组血清及组织样本中miRNA-21-5P的表达水平,分析miRNA-21-5P表达水平与食管鳞癌患者临床病理参数的关系,采用ROC曲线评估其对食管鳞癌的鉴别诊断价值。结果食管鳞癌患者血清miRNA-21-5P的表达水平(3.60±0.09)显著高于食管炎患者(1.01±0.05),差异有统计学意义(t=24.43,P0.05);食管鳞癌患者癌组织中miRNA-21-5P的表达水平(4.36±0.29)显著高于癌旁组织(1.31±0.16),差异亦具有统计学意义(t=20.10,P0.05);而食管癌患者组织中miRNA-21-5P的表达水平显著高于食管炎患者组织(t=20.100,P0.05)。ROC曲线分析结果显示,组织中miRNA-21-5P筛查食管鳞癌的ROC曲线下面积(AUC~(ROC))为0.767(95%CI:0.650,0.859),当cut-off值为0.39时,其敏感性88%,特异性为75%。血清miRNA-21-5P筛查食管鳞癌的AUC~(ROC)为0.671(95%CI:0.549,0.779),当cut-off值为0.63时,其敏感性为80%,特异性为66%。结论 miRNA-21-5P在食管鳞癌血清中的诊断价值与组织相当,或可用于对食管鳞癌的鉴别诊断。

Analysis of Drug Sensitivity of Ceftazidime/avibatan in Carbapenem-resistant Enterobacteriaceae and Its Clinical Efficacy

[ABSTRACT] OBJECTIVE To analyze the sensitivity of ceftazidime-avibatan (CAZ/AVI) in carbapenem-resistant Enterobacteriaceae (CRE) bacterias and its clinical efficacy, so as to provide experimental basis for clinical rational use of CAZ/AVI. METHODS 170 strains of CRE were isolated from the first Affiliated Hospital of Nanjing Medical University from September in 2019 to May in 2020. The carbapenase types of CRE strains were detected by mCIM combined eCIM tests, and the drug sensitivity of CAZ/AVI were detected by Kirby-Bauer method. The suspected drug sensitivity results were reviewed by broth dilution method. Patients were divided into the experimental group and the control group based on the use of CAZ/AVI, thirty-seven pairs of patients were obtained by propensity matching, and the number of effective cases in clinical treatment were compared between the two groups. RESULT A total of 170 CRE strains were detected, of which 130 strains were producing serine-based carbapenemases and 35 strains were producing metal-dependent carbapenemases. The total sensitivity rate of CAZ/AVI was 78.8% (134/170). 52 strains were checked by broth dilution method, and the consistency rate of two methods was 99.4%. The baseline values of experimental group and control group were basically the same. The total effective cases of experimental group were higher than that of control group (P<0.005), also the same in Lower respiratory tract infection (P<0.005). CONCLUSION CAZ/AVI has highly sensitive to CRE producing serine-based carbapenemase, which can be used to treat celiac infection, respiratory infection and bloodstream infection caused by CRE. Clinicians should consider the possible pseudo sensitivity of CAZ/AVI when using the antibiotic.