外周血树突状细胞CD83＋表达对胃癌术后病人预后影响及意义

目的：探讨胃癌外周血中树突状细胞CD83＋表达对预后的影响及意义。方法：选取2010年1月至2011年6月间我科收治的胃癌病人74例进行分析,均为原位癌或仅有局部淋巴结转移,以外周血树突状细胞CD83＋为研究对象,以术后生存时间为标准,对病人手术预后进行分析。结果：所选74例病人术后3周测得外周血树突状细胞CD83＋表达频数平均值（7．32＋1．88脚,以表达频数中位数7．32％为标准将74例病人分为高频组和低频组两组,每组37人。术后总体生存时间108周-413周,平均生存时间（207＋227）周,其中高值组平均生存时间（247＋121）周,低值组平均生存时间（118＋54）周,两组生存时间具有明显差别（P〈O．05）。结论：胃癌外周血中树突状细胞CD83＋的表达对接受手术病人预后有重要影响,可以作为判断病人预后的参考依据,对预后不良者加以对症及时干预以降低死亡率。     

基于Logistic回归模型分析维持性血液透析患者肌少症的危险因素及其对患者生活质量、负性情绪及生存状况的影响

摘要 目的：基于Logistic回归模型分析维持性血液透析（MHD）患者肌少症的危险因素及其对患者生活质量、负性情绪及生存状况的影响。方法：选取江苏省人民医院肾内科肾脏病重症病房于2019年2月-2021年2月期间收治的MHD患者289例,收集所有患者的一般资料,根据是否患有肌少症将患者分为肌少症组（n=71）及非肌少症组（n=218）。采用单因素和多因素Logistic回归模型分析MHD患者肌少症的危险因素,并观察两组生活质量、负性情绪及生存状况。结果：肌少症组、非肌少症组在年龄、透析时间、规律运动、体质量指数（BMI）、人体蛋白质含量（PM）、去脂体质量（FFM）、改良定量主观评估表（MQSGA）评分、血磷、超敏C反应蛋白（hs-CRP）、血肌酐、前白蛋白、白蛋白组间对比差异有统计学意义（P<0.05）。多因素Logistic回归分析,结果显示年龄偏大、透析时间偏长、BMI下降、MQSGA评分偏高、hs-CRP偏高、血肌酐偏高是MHD患者发生肌少症的危险因素,高血磷、规律运动则是其保护因素（P<0.05）。肌少症组患者的精神健康、生理职能、总体健康、生理功能、社会功能、活力、躯体疼痛、情感职能评分均低于非肌少症组（P<0.05）。肌少症组患者的抑郁自评量表（SDS）、焦虑自评量表（SAS）评分高于非肌少症组（P<0.05）。随访1年后,肌少症组的死亡率明显高于非肌少症组（P<0.05）。结论：MHD患者并发肌少症受到年龄、透析时间、BMI、MQSGA评分、hs-CRP、血肌酐、血磷、规律运动等因素的影响,且并发肌少症的患者其抑郁焦虑程度更重,生活质量更差,生存期缩短。     

Tumor expression of B7-H4 predicts poor survival of patients suffering from gastric cancer

To establish the prognostic value of B7-H4 expression by tumor cells in gastric cancer patients, we evaluated the association of B7-H4 expression with clinicopathologic factors and overall survival of gastric cancer patients. A retrospective cohort study including 156 gastric cancer patients was performed in the present report. Immunohistochemical assay was used to evaluate the expression of B7-H4 in the surgical specimens of gastric cancer tissues. Multi-univariate COX model was then used to evaluate the association of B7-H4 expression with the patients’ survival and clinicopathological parameters. B7-H4 expression in the gastric cancer cells was observed in about 44.9% gastric cancer specimens. Univariate analysis demonstrated that there was no correlation between B7-H4 expression and sex, age, histological type, pathological grade or tumor size. In contrast, B7-H4 expression correlated positively with cancer invasiveness and lymph node metastasis. In addition, the median overall survival time of patients with lower B7-H4 expression was 13 months longer than that of patients with higher expression (χ² = 12.38, P < 0.0001), and the median disease-free survival time of patients with lower B7-H4 expression was significantly longer than that of patients with higher expression (33 vs. 16 months, χ² = 14.977, P < 0.0001). After adjustment for other confounding factors, the COX model analysis indicated that the death risk was significantly higher in patients with higher B7-H4 expression than those with lower expression (RR = 1.85, 95% CI = 1.15–2.96). The present study demonstrated that higher B7-H4 expression in cancer cells was associated with poor prognosis of gastric cancer patients. This is consistent with the idea that B7-H4 promotes cancer progression, likely via inhibition of anti-tumor immune responses.     

Correlation between lymphocyte-mediated auto-tumor reactivities and the clinical course

Summary T-cell-enriched lymphocyte populations of 69 lung carcinoma (44 squamous cell, 23 adeno-, and two large cell carcinoma) patients were investigated at the time of surgery for proliferative response to, and/or cytotoxic potential against, freshly separated autologous tumor cells. Tumor-free period and survival time of the patients were correlated with the reactivity obtained in the in vitro tests. The observation time varied between 20 and 78 months (mean 52). Tumor-free period and survival time were longer and survival rate higher in the group with lymphocyte reactivity toward their tumors. In the non-reactive group, all patients but one died within 3 years. Almost all patients had cytotoxic lymphocytes against K562, the three who did not belonging to the category with short survival time.     

Lysosomal-Associated Protein Transmembrane 4 Beta-35 Overexpression Is a Novel Independent Prognostic Marker for Gastric Carcinoma

ObjectiveThe purpose of this work was to analyze the relationships between the expression status of Lysosomal-associated protein transmembrane-4 beta 35 (LAPTM4B-35) in cancerous tissues and clinicopathological characteristics and prognosis of the patients with gastric carcinoma (GC).MethodsThe GC samples from 157 patients in a discovery cohort and 148 patients in a testing cohort with follow-up data were used to validate the feasibility of expression of LAPTM4B-35 protein in predicting GC prognosis. Immunohistochemical staining was used to determine the expression of LAPTM4B-35 protein in precancerous gastric lesions and gastric carcinomas. The correlation between the expression of LAPTM4B-35 and clinicopathologic characteristics of patients with gastric carcinoma was analyzed using chi-square test. Univariate and multivariate analyses were performed to determine the association between LAPTM4B-35 expression and prognosis.ResultsLAPTM4B-35 expression was increased steadily in sequential stages of precancerous gastric lesions. Positive LAPTM4B-35 expression was more frequently detected in patients with distant metastasis (P = 0.023) and III+IV TNM stages (P = 0.042) in the discovery cohort. Kaplan-Meier survival curves and univariate analysis showed that expression of LAPTM4B-35 had a significant impact on overall survival of patients with gastric carcinoma in discovery cohort (P<0.001) and testing cohort (P = 0.001). LAPTM4B-35 expression was an independent prognostic indicator for the overall survival of patients with gastric carcinoma in both cohorts.ConclusionsThe present research demonstrated that LAPTM4B-35 over-expression was an independent factor in gastric carcinoma prognosis. LAPTM4B gene may be a useful target of interventions slowing the progression of precancerous gastric lesions and a new therapy method to improve the prognosis of gastric carcinoma.     

Autosomal dominant cyclic hematopoiesis: exclusion of linkage to the major hematopoietic regulatory gene cluster on chromosome 5

This is an investigation into the finding that patients with primary hyperparathyroidism caused by Water Clear Cell Hyperplasia (WCCH) frequently belong to blood group O. Two control groups were defined from the same time period as 32 cases of WCCH treated at our clinic: one was a consecutive patient series with other forms of primary hyperparathyroidism (n=864) and the other was the population in a geographically defined area in Sweden (n=59,862). The blood group distribution of the patients with WCCH differed from the distribution of the patients with other forms of primary hyperparathyroidism with high significance (P=0.00040). The blood group distribution did not differ between the two control groups. Strong associations between disease and HL-A type have previously been described, while associations found between disease and ABO blood groups were weaker. The association between WCCH and blood group O described here is by far the strongest association with the ABO system demonstrated to date. It is possible that the presence of an O-allele is a prerequisite for the development of WCCH.     

腹腔镜解剖性肝切除治疗肝细胞癌的临床观察

目的:探讨腹腔镜解剖性肝切除治疗肝细胞癌的临床效果及安全性。方法:选择2011年2月~2013年8月在我院进行诊治的肝细胞癌患者90例,将其随机分为治疗组与对照组,每组各45例。治疗组采用腹腔镜解剖性肝切除治疗,对照组采用开腹解剖性肝切除,两组术后都常规化疗3个月,观察和比较两组术中出血量、术后肛门排气时间和术后住院时间,并发症的发生情况及术前后血清谷氨酸转移酶(ALT)与天冬氨酸转移酶(AST)的水平。结果:与对照组相比,治疗组的术中出血量、术后肛门排气时间和术后住院时间均明显降低或缩短(P0.05),术后3个月的膈下积液、切口感染、肺部感染、胆漏的发生率明显降低(P0.05)。两组术前血清ALT与AST值对比差异无统计学意义(P0.05);术后1周,两组的ALT与AST值都明显升上(P0.05);术后3个月,治疗组的ALT与AST值明显低于对照组(P0.05)。所有患者随访到2015年8月,治疗组的中位生存期为(18.33±3.11)个月,而对照组为(12.46±2.19)个月,较治疗组明显缩短(P0.05)。结论:腹腔镜解剖性肝切除治疗肝细胞癌具有更好的微创性,能减少近期并发症的发生,促进肝功能的恢复,且能够延长患者的生存时间。     

术前预后营养指数对肺鳞状细胞癌患者术后复发及死亡的预测价值分析

摘要 目的：探讨术前预后营养指数（PNI）与肺鳞状细胞癌患者预后的关系及对术后复发、死亡的预测效能。方法：纳入2017年1月-2019年1月在我院接受治疗的78例肺鳞状细胞癌患者,所有患者均具有完整的临床资料及病理信息,对其进行门诊复查随访3年,除去失访病例共纳入76例患者资料,期间共有43例患者复发、37例患者死亡;按照复发及死亡情况将该76例患者分别分为复发组（n=43）及未复发组（n=33）,死亡组（n=37）及存活组（n=39）,分别使用单因素和多因素Logistic回归分析影响肺鳞状细胞癌患者复发及死亡的独立危险因素;采用受试者工作特征（ROC）曲线分别分析PNI在肺鳞状细胞癌患者术后复发及死亡的预测效能及最佳截断值。结果：单因素分析显示,TNM分期、吸烟年限、糖尿病、家族史、PNI是影响肺鳞状细胞癌患者术后复发的相关因素（P＜0.05）;性别、年龄、TNM分期、BMI、吸烟史、吸烟年限及PNI是影响肺鳞状细胞癌患者术后死亡的相关因素（P＜0.05）。多因素Logistic回归模型分析显示,TNM分期为Ⅲ期、吸烟年限较长、家族史是引发肺鳞状细胞癌患者术后复发的独立危险因素,PNI为保护因素（P＜0.05）;另外男性、年龄较大、TNM分期为Ⅲ期、吸烟年限较长是引发肺鳞状细胞癌患者术后死亡的独立危险因素,PNI为保护因素（P＜0.05）;ROC分析显示PNI在预测肺鳞状细胞癌患者术后复发的曲线下面积为0.726,敏感度为0.814,特异度为0.667,最佳截断值为48;PNI在预测肺鳞状细胞癌患者术后存活的曲线下面积为0.787,敏感度为0.838,特异度为0.718,最佳截断值为50。结论：PNI对肺鳞状细胞癌患者术后复发及生存均具有较高的预测效能,提高PNI水平对改善肺鳞状细胞癌患者的预后具有积极作用。     

格拉司琼联合隔药灸治疗肝癌介入术后恶心呕吐临床观察

目的:观察格拉司琼联合隔药灸治疗肝癌介入术后恶心呕吐临床疗效。方法:将符合纳入标准的肝癌介入术后恶心呕吐患者72例,分为治疗组与对照组,每组36例,对照组给予注射用盐酸格拉司琼静脉滴注治疗,治疗组在对照组的基础上给予隔药灸治疗。观察两组患者恶心、呕吐症状、胃液引流量及胃管留置时间,统计临床疗效。结果:治疗后治疗组在恶心、呕吐症状评分、胃液引流量、胃管留置时间方面明显均低于对照组(均P0.05)。治疗组、对照组临床疗效总有效率分别为91.67%、72.22%,比较有统计学意义(P0.05)。结论:格拉司琼联合隔药灸可以明显改善肝癌介入术后恶心呕吐症状,缩短胃管留置时间,临床疗效显著。     

不同年龄女性急性ST段抬高型心肌梗死患者冠状动脉病变特点、PPCI治疗临床疗效的差异及院内死亡的危险因素分析

摘要 目的：分析不同年龄女性急性ST段抬高型心肌梗死（STEMI）患者冠状动脉病变特点、经急诊经皮冠状动脉介入（PPCI）治疗后的临床疗效差异及院内死亡的危险因素。方法：选取2018年1月~2022年3月期间在我院接受PPCI治疗的女性STEMI患者408例,根据患者不同的发病年龄将其分为A组（年龄≤65岁,n=161）与B组（年龄>65岁,n=247）。对比不同的发病年龄PPCI冠状动脉病变特点、治疗后的临床疗效差异及院内不良事件发生情况。单因素和多因素Logistic回归分析女性STEMI患者院内死亡的危险因素。结果：A组、B组的病变血管数量、钙化病变组间对比有统计学差异（P<0.05）。A组、B组的病变血管部位、术前TIMI血流分级、分叉病变组间对比无统计学差异（P>0.05）。两组主动脉内囊反搏术比例组间对比未见明显差异（P>0.05）,B组症状发生到血管开通时间（S-to-D）、门-球囊扩张时间（D-to-B）时间长于A组（P<0.05）。两组术中死亡、支架内血栓、BARC3~5级出血比例组间对比无统计学差异（P>0.05）。B组术后死亡的发生率低于A组（P<0.05）。根据患者不同的预后结局分为存活组（n=369）和死亡组（n=39）。单因素分析结果显示女性STEMI患者院内死亡与年龄、糖尿病、体质量指数（BMI）、Killip心功能分级、术前TIMI血流分级、术后TIMI血流分级、住院天数、S-to-D时间、D-to-B时间、收缩压（SBP）、舒张压（DBP）、白细胞计数（WBC）、中性粒细胞、血小板体积分布宽度（PDW）、左心室射血分数（LVEF）、肌酸激酶同工酶（CK-MB）有关（P<0.05）。多因素Logistic回归分析,结果显示年龄偏大、LVEF偏低、CK-MB偏高、术后TIMI血流分级0~I级、S-to-D时间偏长是女性STEMI患者院内死亡的危险因素（P<0.05）。结论：不同年龄女性STEMI患者冠状动脉病变特点、且PPCI 的治疗效果存在一定的差异。此外,年龄偏大、LVEF偏低、CK-MB偏高、术后TIMI血流分级0~I级、S-to-D时间偏长是女性STEMI患者院内死亡的危险因素。     

Perioperative blood transfusion is associated with poorer survival in patients with gastric cancer

The putative prognostic significance of perioperative blood transfusions on gastric cancers is controversial and the published results are contradictory. The aim of this study was to evaluate the prognostic influence of transfusion on Chinese gastric cancer surgery. Six hundreds and seventy-six patients who underwent curative gastrectomy for gastric cancer from 2000 to 2004 were retrospectively reviewed. Uni- and multivariate analyses of the incidence and amount of transfusion, and a comparison of the clinicopathological features were performed. Subgroup analyses of prognosis according to stage, tumor size, and pretreatment anemia were carried out. Blood transfusion was significantly associated with older age (>60 year), larger tumor (>6 cm), upper and middle location, surgical margin status, and pretreatment anemia. In addition, tumors in the transfused group were more advanced in depth of invasion, nodal stage, and TNM stage. No significant relationship was found between the amount of transfused blood and prognosis. Subgroup analyses of prognosis according to stage showed significant differences in stages II and III, between the transfused and nontransfused groups. Significant difference between the transfused and nontransfused groups could be observed in two subgroups of tumor size. Patients with or without anemia in the nontransfused group both had a longer survival time than those in the transfused group. On multivariate analysis, transfusion was shown to be an independent risk factor for poor prognosis. This study suggests that perioperative blood transfusion is associated with a significantly worse prognosis following gastric cancer surgery. The parameters such as advanced stage, tumor size, and anemia do not affect its prognostic value.     

重症监护病房长期机械通气患者撤机困难的原因及死亡影响因素分析

目的:探讨重症监护病房(ICU)长期机械通气患者撤机困难的原因及撤机死亡的影响因素。方法:对2015年6月至2018年10月我院收治的80例长期机械通气患者的临床资料进行回顾性分析,按照患者撤机结果分为撤机成功组52例和撤机困难组28例,根据患者存活情况分为存活组59例和死亡组21例。比较各组临床资料,分析撤机困难的原因及撤机死亡的影响因素。结果:撤机困难组年龄、心功能不全比例、多器官功能障碍(MODS)比例、呼吸机相关肺炎(VAP)比例、肝功能不全比例、肾功能不全比例、血尿素氮显著高于撤机成功组,机械通气时间、气管切开时间显著长于撤机成功组,血清白蛋白显著低于撤机成功组(P0.05)。死亡组年龄、合并糖尿病比例、心功能不全比例、MODS比例、VAP比例、肝功能不全比例、肾功能不全比例、血尿素氮显著高于存活组,机械通气时间、气管切开时间显著长于存活组,血清白蛋白显著低于存活组(P0.05)。多因素Logistic回归分析显示:年龄、合并糖尿病、MODS、VAP、机械通气时间、气管切开时间、血清白蛋白是ICU长期机械通气患者撤机死亡的影响因素(P0.05)。结论:患者治疗期间发生脏器功能不全或器官功能衰竭、机械通气时间较长、气管切开时间较长、营养状态较差是长期机械通气患者撤机困难的主要原因,年龄、合并糖尿病、MODS、VAP、机械通气时间、气管切开时间、血清白蛋白是ICU长期机械通气患者撤机死亡的影响因素。     

Correlation analysis of lymphocyte-monocyte ratio with pathological complete response and clinical prognosis of neoadjuvant chemotherapy in patients with breast cancer

PurposeInflammation plays an important role in tumor proliferation, metastasis, and chemotherapy resistance. Peripheral blood lymphocyte-monocyte ratio (LMR) has been reported to be closely associated with the prognosis of many tumors, such as certain hematologic malignancies and gastric cancer. However, the association in breast cancer is still not clear. This study investigated the relationship between LMR with pathological complete response and clinical prognosis of neoadjuvant chemotherapy in patients with breast cancer, to provide convenient and accurate predictive indicators for pathological complete response (pCR) and prognosis.MethodsThe clinicopathological data of 192 female breast cancer patients who received neoadjuvant chemotherapy and surgery in Harbin Medical University Tumor Hospital from January 2013 to August 2017 were retrospectively analyzed. Blood lymphocytes and monocytes were obtained by peripheral venous punctures.ResultsCompared with the low LMR group, pCR was more easily obtained in the high LMR group (P=0.020); Subgroup analysis showed that patients with the high LMR and HER-2(+) group were more likely to obtain pCR (P=0.011).Univariate andmultivariate results showed that the overall survival (OS) and disease free survival (DFS) of the high LMR group were longer than that of the low LMR group.ConclusionLMR and HER-2 status are correlated with pCR of neoadjuvant chemotherapy in breast cancer patients and are independent predictors of pCR after neoadjuvant chemotherapy in breast cancer patients. Meanwhile, both LMR and T stage of tumor are independent prognostic factors of breast cancer patients, with good predictive value.     

Blood groups in relation to carcinoma of cervix uteri.

Data are presented on AB0 and RhD blood groups in 186 patients suffering from carcinoma of cervix uteri and 274 controls from Delhi, India. A strong association is observed between carcinoma patients and blood group A, and a slightly weaker association with blood group B. There is no significant association with RhD blood group. The available data in other populations confirm the association with AB0 blood group.     

NLR、PLR、LMR与乳腺癌新辅助化疗疗效及预后的关系研究

摘要 目的：探讨化疗前外周血中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）与乳腺癌患者新辅助化疗疗效及预后的关系。方法：选择2016年10月至2018年1月在安徽医科大学附属安庆第一人民医院进行新辅助化疗的乳腺癌患者105例为研究对象,根据新辅助化疗疗效分为病理完全缓解（pCR）组（26例）和非pCR组（79例）。比较pCR组和非pCR组化疗前外周血NLR、PLR、LMR;采用受试者工作特征（ROC）曲线分析化疗前外周血NLR、PLR、LMR对乳腺癌患者新辅助化疗病理疗效预测价值。所有患者术后随访5年,根据ROC曲线确定的NLR、PLR、LMR最佳截断值分为高NLR、PLR、LMR组和低NLR、PLR、LMR组,采用K-M生存曲线分析不同NLR、PLR、LMR组5年无病生存期（DFS）;单因素和多因素COX回归分析预后不良的影响因素。结果：pCR组化疗前NLR、PLR均低于非pCR组（P＜0.05）,LMR高于非pCR组（P＜0.05）。化疗前NLR、PLR、LMR三项联合预测新辅助化疗病理疗效的曲线下面积（AUC）均大于各指标单独预测。K-M生存曲线分析显示,化疗前高NLR、PLR组5年DFS分别低于低NLR、PLR组（P＜0.05）,高LMR组5年DFS高于低LMR组（P＜0.05）;多因素COX回归分析显示,NLR、PLR升高是乳腺癌预后的危险因素,LMR升高是保护因素（P<0.05）。结论：pCR组化疗前NLR、PLR更低,LMR更高,高NLR、PLR和低LMR患者5年DFS更低。NLR、PLR、LMR对新辅助化疗病理疗效具有一定的预测价值,三项联合能为乳腺癌的新辅助化疗评估提供重要参考依据。     

何首乌苷通过激活BDNF/TrkB信号通路拮抗H2O2诱导的大鼠海马神经元氧化损伤

探讨脑源性神经营养因子/酪氨酸激酶受体B(BDNF/TrkB)信号通路激活参与何首乌苷(PMG)对过氧化氢(H2O2)诱导神经元氧化应激损伤的保护作用。实验采用神经元原代培养,建立大鼠乳鼠海马神经元氧化应激损伤模型。实验结果显示高浓度的H2O2与MTT测定的细胞存活率降低相关,选择细胞存活率在40%~50%之间的200μmol/LH2O2浓度作为氧化应激损伤的实验浓度。与模型组相比,PMG预处理组(200μmol/L)可抑制H2O2诱导的神经元损伤(P<0.001)。TUNEL和β-微管蛋白III荧光染色显示PMG保护H2O2诱导的神经细胞损伤,明显降低细胞凋亡率(P<0.001),细胞骨架形态恢复正常。与PMG+H2O2预处理组相比较,当加入BDNF/TrkB信号转导通路阻断剂K252a后,PMG+H2O2+K252a组神经元细胞存活率大幅度下降(P<0.01),细胞骨架形态呈损伤状态。同时,我们发现PMG预处理恢复H2O2诱导的BDNF和P-TrkB的低表达水平,并且用K252a阻断BDNF/TrkB信号传导抑制了PMG对BDNF和P-TrkB表达水平的影响(P<0.01)。综上所述,何首乌苷可能通过激活BDNF/TrkB信号转导通路及维护神经元骨架的完整,实现对大鼠海马神经元氧化应激损伤的拮抗作用。     

胃癌组织中Bag-1蛋白表达特点及与临床病理学特征、预后的关系

目的:探讨Bc1-2相联系的抗凋亡基因1(Bag-1)蛋白在胃癌组织中的表达及与患者临床病理学特征、预后的关系。方法:选取病理科收集的79例胃癌组织及30例癌旁组织,标本收集时间2010年2月至2013年12月,采用免疫组化SP染色检测两组标本中的Bag-1蛋白表达水平,并分析Bag-1蛋白表达与胃癌患者临床病理学、预后的关系。结果:胃癌组织中的Bag-1蛋白阳性表达率65.82%显著的高于癌旁组织的13.33%(P0.05);Bag-1蛋白阳性表达的胃癌患者3年生存率30.77%显著的低于阴性表达患者的55.56%(P0.05);Bag-1蛋白阳性和阴性表达的患者1年以及2年生存率相差不大,差异无统计学意义(P0.05);Bag-1蛋白阳性表达的胃癌患者3年生存率30.77%显著的低于阴性表达患者的55.56%(P0.05)。结论:胃癌组织中的Bag-1蛋白高表达,并且与患者的胃癌临床分期和淋巴结转移以及预后有关。     

Gastroprotective effect of leptin on gastric mucosal injury induced by ischemia-reperfusion is related to gastric histamine content in rats

Leptin has cytoprotective effect to gastric mucosal injury in rats. We aimed to test the hypothesis that leptin induced histamine is involved in the prevention of ischemia-reperfusion (I/R) induced gastric mucosal injury in rats. At the end of the 30 min celiac artery occlusion and 12h reperfusion process, serum and gastric tissue samples were taken from three group of rats to measure oxidative status, histamine levels and for histological examinations. Leptin decreased ulcer and polymorphonuclear leukocyte (PMNL) index, and serum malondialdehyde (MDA) and protein carbonyl content but increased gastric tissue histamine levels. We concluded that leptin exerts a protective effect on gastric mucosa to I/R induced gastric injury probably through increasing tissue histamine content which, in turn, maintain the gastric mucosal blood flow.     

青少年慢性粒细胞白血病急变临床分析

目的:分析青少年慢性粒细胞白血病(CGL)急变患者临床表现及实验检查特点,以提高对青少年CGL急变临床特点的认识。方法:将CGL急变患者按年龄分组,将青少年组和中老年组患者的急变时间、确诊时和急变时的脾脏大小、白细胞和血小板数目、急变时骨髓幼稚细胞的比例,以及患者的总生存时间、急变后生存时间进行对比分析。结果:青少年组和中老年组的脾脏大小、确诊时血小板数目、急变时的白细胞数目、急变时间、以及总生存时间无显著性差异;青少年组确诊时的白细胞数目较中老年组高,青少年组的急变后生存时间较长。结论:青少年CGL患者的临床表现及实验室检查结果具有CGL的普遍特征,但其确诊时白细胞数目较高,急变后生存时间较长。     

Bayesian approaches to joint cure-rate and longitudinal models with applications to cancer vaccine trials

Complex issues arise when investigating the association between longitudinal immunologic measures and time to an event, such as time to relapse, in cancer vaccine trials. Unlike many clinical trials, we may encounter patients who are cured and no longer susceptible to the time-to-event endpoint. If there are cured patients in the population, there is a plateau in the survival function, S(t), after sufficient follow-up. If we want to determine the association between the longitudinal measure and the time-to-event in the presence of cure, existing methods for jointly modeling longitudinal and survival data would be inappropriate, since they do not account for the plateau in the survival function. The nature of the longitudinal data in cancer vaccine trials is also unique, as many patients may not exhibit an immune response to vaccination at varying time points throughout the trial. We present a new joint model for longitudinal and survival data that accounts both for the possibility that a subject is cured and for the unique nature of the longitudinal data. An example is presented from a cancer vaccine clinical trial.