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A prospective study: intraoperative 125I radioactive seed implant therapy in advanced esophageal squamous cell carcinoma 一项前瞻性研究:术中125I放射性粒子植入治疗晚期食管鳞癌
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60080-0
Jin Lü, Xiu-feng Cao, B. Zhu, Lü Ji
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引用次数: 0
Expression of co-stimulatory molecules B7-2 and PD-L1 on peripheral blood mononuclear cells in patients with chronic hepatitis B virus infection 慢性乙型肝炎病毒感染患者外周血单个核细胞中共刺激分子B7-2和PD-L1的表达
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60082-4
Lingxia Fei, Shipin Wu, Hongtao Chen

Objective

To explore the roles of the expression of the co-stimulatory molecule, B7-2, and the co-inhibitory molecule, PD-L1, on peripheral blood mononuclear cells in the mechanism of immunotolerance in chronic hepatitis B virus infection.

Methods

Thirty HBV infected patients in the immunoreactive phase and 20 patients in the immunotolerant phase were enrolled in the study, while 20 healthy volunteers were used as controls. RT- PCR and real-time PCR methods were used to detect the expression levels of B7-2 and PD-L1 mRNA in peripheral blood mononuclear cells in chronic HBV infected patients.

Results

The B7-2 expression in immunoreactive and immunotolerant patients was significantly lower than that in the controls (P all < 0.01); B7-2 expression in immunoreactive patients was significantly lower than in immunotolerant patients (P < 0.01). PD-L1 expression in immunoreactive patients and immunotolerant patients was significantly higher than that in normal controls (P all < 0.01). The PD-L1/B7-2 ratios in immunoreactive and immunotolerant patients were significantly higher than that of the healthy controls (P all < 0.01); the PD-L1/B7-2 ratio was significantly higher in the immunoreactive patients than in the immunotolerant patients (P < 0.01).

Conclusion

In chronic HBV infection, changes in the expression of co-stimulatory and co-inhibitory molecules imply a protective adjustment against the patient's immune response that may result in increased immunotolerance and persistent HBV infection.

目的探讨外周血单核细胞中共刺激分子B7-2和共抑制分子PD-L1的表达在慢性乙型肝炎病毒感染免疫耐受机制中的作用。方法选取30例处于免疫反应期的HBV感染者和20例处于免疫耐受期的HBV感染者,同时选取20名健康志愿者作为对照。采用RT- PCR和real-time PCR方法检测慢性HBV感染患者外周血单个核细胞B7-2和PD-L1 mRNA的表达水平。结果B7-2在免疫反应性和免疫耐受患者中的表达明显低于对照组(P均<0.01);B7-2在免疫反应性患者中的表达明显低于免疫耐受患者(P <0.01)。免疫反应性患者和免疫耐受患者的PD-L1表达明显高于正常对照组(P all <0.01)。免疫反应性和免疫耐受患者的PD-L1/B7-2比值显著高于健康对照组(P均<0.01);免疫反应性患者的PD-L1/B7-2比值明显高于免疫耐受患者(P <0.01)。结论在慢性HBV感染中,共刺激和共抑制分子表达的变化暗示了对患者免疫反应的保护性调整,可能导致免疫耐受性增加和HBV持续感染。
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引用次数: 0
Differentially expressed gene in osteosarcoma cell lines with different metastatic potentials 不同转移潜能骨肉瘤细胞系差异表达基因
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60083-6
Xinzhi Li , Lin Meng , Anming Chen , Fengjin Guo , Zhenqiang Luo , Heng Zeng

Objective

To study the expression of osteosarcoma metastasis associated gene using a cDNA microarray, and screen new candidate genes related to the development, progress and osteosarcoma metastasis.

Methods

Total RNA of a low metastatic osteosarcoma and a high metastatic osteosarcoma (M6 and M8 cell lines, respectively) was extracted, purified to mRNA and then reverse transcribed to cDNA. M6 was used as the experimental group and M8 as the control group, and the gene expression of cells from both of these two sublines was investigated using cDNA microarrays containig 8064 cDNA clones. The cDNA of M6 was labeled with cy3 and the cDNA of M8 was labeled with cy5. The two sublines were hybridized with the cDNA microarray. The hybridization signals were scanned with a Generation III array scanner and analyzed by Imagequant 5.0 software.

Results

There were 330 differentially expressed genes between M6 and M8. In the M6 subline,152 genes were up-regulated and 178 genes were down-regulated compared to the M8 subline. These genes could be classified according to their function. Cell growth-related genes that were down-regulated included CCNG1, CDC2, APC10, and RPA3, while expression of the tumor suppressor genes, CDKN1A and CDKN2D, was up-regulated. Other genes that were differentially expressed included those that have been implicated in the regulation of signal transduction, metabolism and apoptosis.

Conclusion

This study exploits a cDNA microarray approach to identifying genes that may be associated with metastasis. The gene expression profiles of osteosarcoma cell lines is a potentially important index in the search of new candidate genes related to tumor occurrence, development and metastasis.

目的利用基因芯片技术研究骨肉瘤转移相关基因的表达,筛选与骨肉瘤发生、发展及转移相关的新候选基因。方法提取低转移性骨肉瘤和高转移性骨肉瘤(分别为M6和M8细胞系)的总RNA,纯化为mRNA,然后逆转录为cDNA。以M6为实验组,M8为对照组,利用含有8064个cDNA克隆的cDNA芯片研究这两个亚系细胞的基因表达情况。M6的cDNA用cy3标记,M8的cDNA用cy5标记。用cDNA芯片对这两个亚系进行杂交。杂交信号用三代阵列扫描仪扫描,用Imagequant 5.0软件分析。结果M6与M8之间存在330个差异表达基因。与M8亚系相比,M6亚系中有152个基因上调,178个基因下调。这些基因可以根据它们的功能进行分类。下调细胞生长相关基因CCNG1、CDC2、APC10和RPA3,上调肿瘤抑制基因CDKN1A和CDKN2D的表达。其他差异表达的基因包括那些参与信号转导、代谢和凋亡调节的基因。结论本研究利用cDNA微阵列技术鉴定可能与肿瘤转移相关的基因。骨肉瘤细胞系的基因表达谱是寻找与肿瘤发生、发展和转移相关的新候选基因的潜在重要指标。
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引用次数: 1
The efficacy and tolerability of lamotrigine adjunctive/monotherapy in patients with partial seizures refractory to poly-AEDs 拉莫三嗪辅助/单药治疗多抗癫痫药难治性部分发作患者的疗效和耐受性
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60078-2
Chunjie Song , Huiling Chen , Xiaoyong Wang , Hui Wang , Qi Wan

Objective

This study was designed as an open-label trial to assess the effects of changing the antiepileptic drugs (AEDs) regi- men to lamotrigine (LTG) as adjunctive/monotherapy in patients with partial seizures who were dissatisfied with their drug regimen because of intractable seizures.

Methods

The patients were recruited from multicenters using the following criteria: age⩾18 years; at least 3 seizures per month during the last 16 weeks; previous use of at least 3 AEDs. The study involved a baseline phase and 2 experimental phases: LTG was first added to the regimen, and then patients could gradually change to LTG monotherapy if their seizures were reduced by at least 50 percent/month. Tolerability, the primary end point, was assessed using the Liverpool Adverse Experience Profile (LAEP). Secondary end points included quality of life, as measured with the Quality of Life in Epilepsy-31 inventory. Reductions in seizures from baseline throughout each phase were also analyzed.

Results

One hundred and fourteen patients aged between 18 and 52 years (age 27.8±13.2 years; 71 men and 43 women) were enrolled. After adding LTG, 105 patients (92.11%) completed adjunctive therapy. Upon completion of the adjunctive phase, mean improvement from baseline was 2.6 points on the LAEP (p=0.037). The overall score on the QOLIE-31 improved by 8.49 points from baseline (p=0.023). At the end of the trial, 26 (22.81%) of patients completed LTG monotherapy, and 65 patients (57.02%) experienced at least 50% reduction in seizure frequency compared to baseline, The mean improvement from baseline was 5.1 points on the LAEP (p=0.0059), and the overall score on the QOLIE-31 score improved by 12.72 points from baseline(p=0.0071). Twenty-two (19.30%) patients reported adverse effects and 9 patients discontinued participation in the trial because of adverse effects.

Conclusion

For patients with partial seizures who were dissatisfied with their AED regimen because of intractable seizures, adding LTG to the drug regimen was well tolerated and effective in improving the quality of life and controlling seizures. Furthermore, switching to LTG monotherapy was associated with further improvement.

目的:本研究是一项开放标签试验,旨在评估将抗癫痫药物(aed)方案改为拉莫三嗪(LTG)作为辅助/单药治疗因难治性癫痫发作而对其药物方案不满意的部分癫痫发作患者的效果。方法使用以下标准从多中心招募患者:年龄大于或等于18岁;在过去16周内每月至少发作3次;既往使用过至少3种aed。该研究包括基线期和2个实验期:首先将LTG添加到方案中,然后如果患者的癫痫发作减少至少50% /月,患者可以逐渐改为LTG单药治疗。耐受性,主要终点,评估使用利物浦不良经历档案(LAEP)。次要终点包括生活质量,用癫痫-31量表的生活质量来衡量。还分析了每个阶段癫痫发作从基线的减少情况。结果18 ~ 52岁患者114例(年龄27.8±13.2岁;71名男性和43名女性)被纳入研究。添加LTG后,105例患者(92.11%)完成了辅助治疗。辅助期结束后,LAEP平均较基线改善2.6分(p=0.037)。QOLIE-31总分较基线提高8.49分(p=0.023)。试验结束时,26例(22.81%)患者完成LTG单药治疗,65例(57.02%)患者癫痫发作频率较基线降低至少50%,LAEP平均较基线改善5.1分(p=0.0059), QOLIE-31评分总分较基线改善12.72分(p=0.0071)。22例(19.30%)患者报告了不良反应,9例患者因不良反应而停止参与试验。结论对于因难治性癫痫发作而对AED方案不满意的部分癫痫患者,在药物方案基础上加用LTG可改善生活质量,有效控制癫痫发作。此外,切换到LTG单药治疗与进一步改善相关。
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引用次数: 4
Evaluation of the immunochromatographic strip test for the rapid diagnosis of antenatal syphilis in women in Eldoret, Kenya 评价免疫层析试纸快速诊断肯尼亚埃尔多雷特妇女产前梅毒
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60077-0
Lydia B. Nyamwamu , Michael M. Gicheru , Rekha R. Sharma , Albert Kimutai , Willy K. Tonui , Peter Kamau Ngure

Objective

This study compared the performance of the immunochromatographic strip (ICS) to the Venereal Disease Research Laboratory (VDRL) test and Treponema pallidum haemagglutination assay (TPHA) at a primary health care setting.

Methods

The study group was comprised of 150 females randomly drawn from a population of pregnant women attending their first antenatal visit or follow-up visits at West Maternity Hospital in Eldoret Kenya, but without a previous syphilis test during that pregnancy. On-site VDRL, ICS and TPHA tests were performed and immediate treatment provided where appropriate. The performance of the three tests was compared.

Results

The sero-prevalence of syphilis as determined by the VDRL test was 3%. There was no significant difference between the ICS and the VDRL test (P > 0.05). The sensitivity and specificity of the ICS test were 80% and 98.6% respectively, while the negative predictive value (NPV) and positive predictive value (PPV) were both 100%. On the other hand, the sensitivity and specificity of the VDRL test were 66.7% and 99.3%, while the NPV and PPV were 80% and 98.6% respectively. The Treponema pallidum haemagglutination assay was used as a reference test and had sensitivity, specificity, NPV and PPV of 100%.

Conclusion

The diagnostic accuracy of the ICS compared favorably with the VDRL gold standard. The use of the ICS in Kenya can improve the diagnosis of syphilis in health facilities both with and without laboratories and allow community health care workers to make a rapid diagnosis of the disease, and consequently make immediate therapeutic decisions.

目的:本研究将免疫层析试纸(ICS)与性病研究实验室(VDRL)和梅毒螺旋体血凝试验(TPHA)在初级卫生保健机构的性能进行比较。研究小组由150名随机抽取的孕妇组成,这些孕妇在肯尼亚埃尔多雷特的West妇产医院进行了首次产前检查或随访,但在怀孕期间没有进行过梅毒检测。现场进行了VDRL、ICS和TPHA测试,并在适当情况下立即提供治疗。比较了三种测试方法的性能。结果VDRL检测梅毒血清患病率为3%。ICS与VDRL测验之间无显著差异(P >0.05)。ICS检测的敏感性和特异性分别为80%和98.6%,阴性预测值(NPV)和阳性预测值(PPV)均为100%。另一方面,VDRL检测的敏感性和特异性分别为66.7%和99.3%,NPV和PPV分别为80%和98.6%。梅毒螺旋体血凝试验作为参比试验,敏感性、特异性、NPV和PPV均为100%。结论ICS的诊断准确性优于VDRL金标准。在肯尼亚使用综合诊断系统可以改善有实验室和没有实验室的卫生机构对梅毒的诊断,并使社区卫生保健工作者能够迅速诊断这种疾病,从而立即作出治疗决定。
{"title":"Evaluation of the immunochromatographic strip test for the rapid diagnosis of antenatal syphilis in women in Eldoret, Kenya","authors":"Lydia B. Nyamwamu ,&nbsp;Michael M. Gicheru ,&nbsp;Rekha R. Sharma ,&nbsp;Albert Kimutai ,&nbsp;Willy K. Tonui ,&nbsp;Peter Kamau Ngure","doi":"10.1016/S1007-4376(09)60077-0","DOIUrl":"10.1016/S1007-4376(09)60077-0","url":null,"abstract":"<div><h3>Objective</h3><p>This study compared the performance of the immunochromatographic strip (ICS) to the Venereal Disease Research Laboratory (VDRL) test and Treponema pallidum haemagglutination assay (TPHA) at a primary health care setting.</p></div><div><h3>Methods</h3><p>The study group was comprised of 150 females randomly drawn from a population of pregnant women attending their first antenatal visit or follow-up visits at West Maternity Hospital in Eldoret Kenya, but without a previous syphilis test during that pregnancy. On-site VDRL, ICS and TPHA tests were performed and immediate treatment provided where appropriate. The performance of the three tests was compared.</p></div><div><h3>Results</h3><p>The sero-prevalence of syphilis as determined by the VDRL test was 3%. There was no significant difference between the ICS and the VDRL test (<em>P</em> &gt; 0.05). The sensitivity and specificity of the ICS test were 80% and 98.6% respectively, while the negative predictive value (NPV) and positive predictive value (PPV) were both 100%. On the other hand, the sensitivity and specificity of the VDRL test were 66.7% and 99.3%, while the NPV and PPV were 80% and 98.6% respectively. The Treponema pallidum haemagglutination assay was used as a reference test and had sensitivity, specificity, NPV and PPV of 100%.</p></div><div><h3>Conclusion</h3><p>The diagnostic accuracy of the ICS compared favorably with the VDRL gold standard. The use of the ICS in Kenya can improve the diagnosis of syphilis in health facilities both with and without laboratories and allow community health care workers to make a rapid diagnosis of the disease, and consequently make immediate therapeutic decisions.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60077-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75958444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A prospective study: intraoperative 125I radioactive seed implant therapy in advanced esophageal squamous cell carcinoma 一项前瞻性研究:术中125I放射性粒子植入治疗晚期食管鳞癌
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60080-0
Jin Lü, Xiufeng Cao, Bin Zhu, Lü Ji

Objective

To investigated the role of intraoperative iodine-125 (125I) brachytherapy as a treatment option for advanced thoracic esophageal squamous cell carcinoma (ESCC).

Methods

Using preoperative computed tomography (CT)-based staging criteria, between 2000 and 2008, 298 patients with ESCC (stage II-III) were enrolled in this prospective study. With informed consent, patients were randomized into two groups: intraoperative 125I seed implantation and surgery alone (control group). Twenty to forty 125I seeds (0.5 mCi per seed), with a total activity in 10∼30 mCi, and a matched peripheral dose (MPD) of 60∼70 Gy, were implanted under direct visualization. The surgical procedure used in this study was either a radical resection, which involved an esophagectomy through a left thoracotomy with two-field lymphadenectomy, or palliative resection. The postoperative complications were observed and recorded. The location and quality assessment of 125I seeds were assessed using CT scans or X-ray imaging. The short-term efficacy was evaluated according to WHO criteria. The 1, 3, 5 and 7-year survival rates were determined on follow-up.

Results

There was no displacement or loss of 125I seeds. The local recurrence rates in the intraoperative 125I seed implantation group and control group were 14.9% and 38.7%, respectively (P < 0.05). An objective response rate of 92% was observed in the seed implant group, which was significantly higher than 0% in the control group (P < 0.05). There was no significant difference between the two groups when comparing of complications (P > 0.05). The 1-year survival rate of the two groups were not significantly different (P > 0.05). However, the 3, 5 and 7-year survival rates in the united 125I group (64%, 55.3% and 8%, respectively) were statistically different from those in the control group (52%, 29.1% and 1.4%, respectively)(P < 0.05).

Conclusion

Intraoperative 125I seed implantation is safe and effective for advanced ESCC. Seed implantation may reduce the local recurrence rate and improve survival in patients with ESCC. The MPD of 60∼70 Gy, with single 125I seed activity of 0.5 mCi, is reasonable.

目的探讨术中碘125 (125I)近距离放射治疗晚期胸段食管鳞状细胞癌(ESCC)的作用。方法采用术前计算机断层扫描(CT)分期标准,在2000年至2008年期间,298例ESCC患者(II-III期)被纳入这项前瞻性研究。经知情同意后,将患者随机分为术中125I粒子植入组和单纯手术组(对照组)。20 ~ 40粒125I种子(每粒0.5 mCi),总活性在10 ~ 30 mCi,匹配的外周剂量(MPD)为60 ~ 70 Gy,在直接可视化下植入。在本研究中使用的外科手术是根治性切除术,包括食管切除术和左胸双野淋巴结切除术,或姑息性切除术。观察并记录术后并发症。使用CT扫描或x射线成像评估125I种子的位置和质量。根据世卫组织标准评价短期疗效。随访1、3、5、7年生存率。结果125I种子未发生移位或丢失。125I粒子植入组和对照组的局部复发率分别为14.9%和38.7% (P <0.05)。种子植入组的客观有效率为92%,显著高于对照组的0% (P <0.05)。两组患者并发症比较无统计学差异(P >0.05)。两组患者1年生存率差异无统计学意义(P >0.05)。125I联合治疗组3年、5年、7年生存率(分别为64%、55.3%、8%)与对照组(分别为52%、29.1%、1.4%)比较,差异有统计学意义(P <0.05)。结论术中125I粒子植入治疗晚期ESCC安全有效。粒子植入可降低ESCC患者的局部复发率,提高生存率。MPD为60 ~ 70 Gy,单粒125I种子活性为0.5 mCi,是合理的。
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引用次数: 0
Relationship of GSTM1 and GSTT1 genetic variant and markers of oxidative stress and inflammation in smokers with coronary artery disease 冠心病吸烟者GSTM1和GSTT1基因变异与氧化应激和炎症标志物的关系
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60074-5
Changgao Zhou , Jianjin Tang , Mingwei Wang , Jianjun Yan , Qiming Wang , Jun Zhu , Zhijian Yang , Liansheng Wang

Objective

To investigate the role of glutathione S-transferase (GST) genetic variants and markers of oxidative stress and inflammation in smoking- related coronary artery disease (CAD) patients.

Methods

Five hundred and thirty-five Chinese CAD patients were successfully genotyped. Plasma total antioxidant status (TAOS), glutathione, C-reactive protein (CRP), fibrinogen(FIB) and white blood cell count (WBC) were determined to evaluate the oxidative stress and inflammatory response.

Results

GSTM1-0/GSTT1-0 subjects had a higher CRP, FIB, WBC and GSH and a lower TAOS compared to patients with wild-type GSTM1/GSTT1 genes, but there was significant difference only with regards to TAOS. Smokers with the null genotype of GSTT1 had the highest CRP and the lowest TAOS and GSH when compared to the GSTT1-1 genotype with smoking status, or the GSTT1-0 genotype with non-smoking status, or the GSTT1-1 genotype with non-smoking status. However, we found no significant difference between these groups. Also, no significant interaction was observed between genotypes and smoking status in determining CRP levels.

Conclusion

Our results suggest that GST polymorphisms do not modify the effect of smoking on markers of oxidative stress and inflammation in Chinese CAD patients.

目的探讨谷胱甘肽s -转移酶(GST)基因变异及氧化应激和炎症标志物在吸烟相关性冠心病(CAD)患者中的作用。方法对我国535例冠心病患者进行基因分型。通过测定血浆总抗氧化状态(TAOS)、谷胱甘肽、c反应蛋白(CRP)、纤维蛋白原(FIB)和白细胞计数(WBC)来评估氧化应激和炎症反应。结果GSTM1-0/GSTT1-0基因组与野生型GSTM1/GSTT1基因组相比,CRP、FIB、WBC、GSH升高,TAOS降低,但TAOS差异有统计学意义。GSTT1基因型为零的吸烟者与吸烟的GSTT1-1基因型、不吸烟的GSTT1-0基因型、不吸烟的GSTT1-1基因型相比,CRP最高,TAOS和GSH最低。然而,我们发现这两组之间没有显著差异。此外,基因型和吸烟状况之间在决定CRP水平方面没有明显的相互作用。结论GST多态性不能改变吸烟对冠心病患者氧化应激和炎症标志物的影响。
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引用次数: 1
Manganese superoxide dismutase polymorphism and prostate cancer risk: a meta-analysis 锰超氧化物歧化酶多态性与前列腺癌风险:荟萃分析
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60081-2
Bingbing Wei , Yunyun Zhang , Bo Xi , Jiantang Su

Objective

MnSOD plays a vital role in carcinogenesis, partly in that it converts superoxide radical to oxygen and hydrogen peroxide. The conflicting results of studies on the role of MnSOD polymorphism (Val−9Ala) with the risk of prostate cancer encouraged us to perform a meta-analysis to examine the association.

Methods

A comprehensive search was conducted to examine all the eligible studies of MnSOD polymorphism and prostate cancer risk. We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association. The pooled estimates of ORs were computed using the fixed-effects model or random- effects model.

Results

Ten eligible studies, including 4 608 cases and 5 861 controls, were included in this meta-analysis. Overall, individuals with Ala/Ala and Ala/Val genotypes have an increased risk of prostate cancer, compared with those carrying the Val/Val genotype (Ala/Ala vs. Val/Val: OR=1.13; 95% CI=1.02∼1.25; P = 0.020, Pheterogeneity=0.370; Ala/Val vs. Val/Val: OR=1.14; 95% CI=1.04∼1.25; P = 0.004, Pheterogeneity=0.940). This significant association was also found in a dominant model with −9Ala allele (Ala/Ala+Ala/Val vs. Val/Val: OR=1.12; 95% CI: 1.03∼1.22; P = 0.009, Pheterogeneity=0.64). In the subgroup by ethnicity, it was observed that significantly elevated prostate cancer risk was associated with −9Ala allele in Caucasians (Ala/Ala vs. Val/Val: OR=1.14; 95% CI=1.03∼1.27; P = 0.01, Pheterogeneity=0.31; Ala/Val vs. Val/Val: OR=1.14; 95% CI=1.04∼1.24; P = 0.006, Pheterogeneity=0.87) but not in African-Americans. Furthermore, this meta-analysis showed that the −9Ala allele was associated with both nonaggressive and aggressive prostate cancer risks.

Conclusion

Our meta-analysis suggests that MnSOD Val−9Ala polymorphism is associated with prostate cancer risk, especially in Caucasians.

目的nsod在肿瘤发生过程中起重要作用,部分原因是它能将超氧自由基转化为氧和过氧化氢。关于MnSOD多态性(Val−9Ala)与前列腺癌风险作用的研究结果相互矛盾,这促使我们进行荟萃分析来检验这种关联。方法综合检索所有符合条件的MnSOD多态性与前列腺癌发病关系的研究。我们使用比值比(ORs)和95%置信区间(CIs)来评估这种关联的强度。使用固定效应模型或随机效应模型计算ORs的汇总估计。结果共纳入10项符合条件的研究,包括4 608例病例和5 861例对照。总的来说,与携带Val/Val基因型的人相比,Ala/Ala和Ala/Val基因型的人患前列腺癌的风险更高(Ala/Ala vs. Val/Val: OR=1.13;95% CI = 1.02∼1.25;P = 0.020,异质性=0.370;Ala/Val vs. Val/Val: OR=1.14;95% CI = 1.04∼1.25;P = 0.004,异质性=0.940)。在−9Ala等位基因的显性模型中也发现了这种显著关联(Ala/Ala+Ala/Val vs. Val/Val: OR=1.12;95% ci: 1.03 ~ 1.22;P = 0.009,异质性=0.64)。在种族亚组中,观察到白种人前列腺癌风险显著升高与- 9Ala等位基因相关(Ala/Ala vs. Val/Val: OR=1.14;95% CI = 1.03∼1.27;P = 0.01,异质性=0.31;Ala/Val vs. Val/Val: OR=1.14;95% CI = 1.04∼1.24;P = 0.006,异质性=0.87),但在非裔美国人中没有。此外,该荟萃分析显示- 9Ala等位基因与非侵袭性和侵袭性前列腺癌风险均相关。我们的荟萃分析表明,MnSOD Val−9Ala多态性与前列腺癌风险相关,特别是在白种人中。
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引用次数: 1
Reduction in pulmonary complications in high risk patients undergoing surgery for total hip replacement under general anesthesia by preoperative intensive inspiratory muscle training : A randomized controlled clinical trial 一项随机对照临床试验:通过术前强化吸气肌训练减少全麻下全髋关节置换术高危患者的肺部并发症
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60079-4
Bingqiang Ma, Hongguang Bao

Objective

To evaluate the effects of preoperative inspiratory muscle training (IMT) on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hip replacement surgery under general anesthesia.

Methods

Thirty two high-risk patients undergoing elective total hip replacement surgery under general anesthesia were chosen from Nanjing Medical University, Affiliated Nanjing First Hospital. In this single-blind randomized controlled clinical trial, patients were randomly assigned to receive preoperative inspiratory muscle training or conventional treatment (CT). The major effectiveness outcome variables were atelectasis and duration of postoperative hospitalization.

Results

Both groups were comparable prior to surgery. Seven patients in the CT group and 3 in the IMT group developed atelectasis (P = 0.25). Median duration of postoperative hospitalization was 13 days (range, 10∼17 days) in the IMT group versus 16 days (range, 11∼23 days) in the CT group (Mann- Whitney U statistics, Z = −2.22, P = 0.03). Mean postoperative inspiratory pressure was 5% higher in the IMT group.

Conclusion

Preoperative intensive inspiratory muscle training appears to reduce the incidence of atelectasis and duration of postoperative hospitalization in patients at high risk of developing postoperative pulmonary complications who were scheduled for elective total hip replacement surgery under general anesthesia.

目的探讨全麻下选择性全髋关节置换术中肺并发症高危患者术前吸气肌训练(IMT)对肺不张发生率的影响。方法选择南京医科大学附属南京第一医院全麻下行选择性全髋关节置换术的高危患者32例。在这项单盲随机对照临床试验中,患者被随机分配接受术前吸气肌训练或常规治疗(CT)。主要疗效指标为肺不张和术后住院时间。结果两组术前比较具有可比性。CT组7例,IMT组3例发生肺不张(P = 0.25)。IMT组术后住院时间中位数为13天(范围,10 ~ 17天),CT组为16天(范围,11 ~ 23天)(Mann- Whitney U统计,Z = - 2.22, P = 0.03)。IMT组术后平均吸气压力升高5%。结论在全麻下行选择性全髋关节置换术的高危肺并发症患者,术前强化吸气肌训练可减少肺不张的发生率和术后住院时间。
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引用次数: 2
Diagnosis and surgical treatment of intraveneous leiomyomatosis extending into the heart: two cases report and review of the literature 延伸至心脏的静脉平滑肌瘤病的诊断与手术治疗:2例报告并文献复习
Pub Date : 2009-09-01 DOI: 10.1016/S1007-4376(09)60075-7
Xiaowei Wang, Lin Zhang, Yijiang Chen, Shijiang Zhang, Jianwei Qin, Yanhu Wu, Jinhua Luo

Objective

To investigate the clinical characteristics, diagnosis and surgical treatment of intravenous leiomyomatosis (IVL), and outline the differences between Chinese and overseas cases.

Methods

Clinical data of two IVL cases, treated in our hospital, were analyzed retrospectively and the related literature was also reviewed. The data of preoperative diagnostic rate, surgical procedures, and postoperative recurrence between patients in China and other countries were compared.

Results

The first stage operation was performed successfully in 2 patients. However, they refused subsequent therapies, including a second stage operation to excise the remnants of the tumor, uterus, bilateral oviducts and ovaries, and anti-estrogen therapy. Both suffered from IVL recurrence, one at 6-month and the other at 9-month, and died at 16-month and 12-month respectively after the first stage surgery. Worldwide reports of 110 IVL cases were reviewed, which included 28 cases in China and 82 cases in other countries. In the majority of the Chinese patients, tumors only extended into the right atrium rather than the right ventricle (RA 22 cases vs RV 4 cases). However, among the overseas patients, the rate of extension into the right atrium was similar to that of extension into the right ventricle (RA 41 cases vs RV 38 cases). The rate of hysterectomies was not significantly different between Chinese and overseas patients (67.86% vs 55.9%, P=0.278). The rate of correct preoperative diagnosis in the Chinese patients was significantly lower than that in the overseas patients (32.14% vs 80%, P=0.000002), as well as the rate of complete excision of the tumor (22.7% vs 75.5%, P=0.000001). The proportion of patients who undergoing a single-stage or a two-stage operation was similar in Chinese and overseas patients. The recurrence rate was significantly higher in the Chinese patients than in the overseas patients (36.8% vs 9.1%, P=0.0055), and the patients with tumor recurrence were partial tumor excision patients.

Conclusion

The possibility of IVL should be considered if echocardiography in female patients demonstrates a tumor in the right heart and a mass in the inferior vena cava (IVC). Further imaging should be performed to confirm the diagnosis. The correct diagnosis and accurate preoperative delineation of tumor extension are essential for an optimal surgical outcome. The key point in IVL treatment is the complete excision of tumors (single-stage or two-stage surgical procedure).

目的探讨静脉内平滑肌瘤病(IVL)的临床特点、诊断和手术治疗,并总结国内外病例的差异。方法回顾性分析我院收治的2例IVL患者的临床资料,并复习相关文献。比较国内外患者术前诊断率、手术方式、术后复发率等资料。结果2例患者一期手术成功。然而,他们拒绝了后续的治疗,包括切除肿瘤残余、子宫、双侧输卵管和卵巢的第二阶段手术,以及抗雌激素治疗。2例患者均出现IVL复发,1例6个月,1例9个月,分别于一期手术后16个月和12个月死亡。回顾了110例IVL病例的全球报告,其中中国28例,其他国家82例。在大多数中国患者中,肿瘤仅扩展到右心房而不是右心室(RA 22例vs RV 4例)。然而,在海外患者中,延伸到右心房的比例与延伸到右心室的比例相似(RA 41例对RV 38例)。中国患者与海外患者子宫切除术率差异无统计学意义(67.86% vs 55.9%, P=0.278)。中国患者术前诊断率(32.14% vs 80%, P=0.000002)和肿瘤完全切除率(22.7% vs 75.5%, P=0.000001)均显著低于海外患者。在中国和海外患者中,接受单期或两期手术的患者比例相似。中国患者的复发率明显高于海外患者(36.8% vs 9.1%, P=0.0055),肿瘤复发的患者为部分肿瘤切除患者。结论女性患者超声心动图显示右心肿瘤及下腔静脉肿块时,应考虑下腔静脉病变的可能性。应进一步影像学检查以确诊。正确的诊断和准确的术前划定肿瘤扩展是必不可少的最佳手术结果。IVL治疗的关键是肿瘤的完全切除(单期或两期手术)。
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引用次数: 1
期刊
Journal of Nanjing Medical University
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