Effect of Zhenwu Decoction and Lingguizhugan Decoction combining dagelin in the treatment of diabetes nephropathy with Spleen and Kidney Yang Deficiency and influence on blood glucose control,inflammatory factors and cellular immunity
Objective To explore the effect of Zhenwu Decoction and Lingguizhugan Decoction combining Dagelin on the treatment of diabetes nephropathy(DN) patients with spleen Kidney Yang Deficiency and the influence of blood glucose control, inflammatory factors and cellular immunity. Methods From March 2020 to March 2022, 102 patients with DN of spleen kidney yang deficiency type were selected from the Endocrinology Department of Hubei Integrated Hospital of Traditional Chinese and Western Medicine. According to the method of random number table, they were divided into control group and observation group, with 51 cases each. Both groups were given routine treatment, and the control group was given daggliptin treatment, while the observation group was treated with Zhenwu Decoction and Lingguizhugan Decoction on the basis of the control group. After 8 weeks of treatment, the clinical efficacy, blood glucose control [fasting blood glucose(FPG), 2 h postprandial blood glucose(2 hPG), glycosylated hemoglobin(HbA1 c)], renal function [blood creatinine(SCR), urinary microalbumin excretion rate(UAER), glomerular filtration rate(eGFR)], and inflammatory factors [tumor necrosis factor-α(TNF-α), Interleukin-6(IL-6), IL-1β], The level of cellular immunity(CD8+, CD3+, CD4+, CD4+/CD8+). Results Out of 102 patients, 3 patients withdrew and 99 patients successfully completed the treatment, including 44 patients in the control group and 45 patients in the observation group. The total effective rate of the observation group was higher than that of the control group(93.33% vs.75.00%,χ2=5.641,P=0.018). After 8 weeks of treatment, FPG, 2 hPG, HbA1 c in the observation group were lower than those in the control group(t=7.143, 4.699, 4.924,P<0.001). BUN, SCR, UAER were lower than those in the control group, and eGFR was higher than those in the control group(t=4.735, 7.244, 3.519, 5.460,P<0.001). TNF-α, IL-6, IL-1β were lower than that in the control group(t=6.496, 4.732, 3.379,P<0.001). CD8+ was lower than that in the control group, and CD3+, CD4+, CD4+/CD8+ were higher than that in the control group(t=5.781, 11.331, 5.030, 6.228,P<0.001). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Zhenwu Decoction and Lingguizhugan Decoction combining Dagelin can more effectively improve immune function, reduce inflammatory reaction level, and improve blood glucose control and renal function in patients with spleen kidney yang deficiency type DN.
Study on the oncological efficacy, pulmonary function, recurrence rate and safety of thoracoscopic lung cancer precise resection strategy
Objective To compare the oncological efficacy, lung function, recurrence rate and safety of precise thoracoscopic lung cancer resection strategy with conventional thoracoscopic surgery. Methods From May 2019 to May 2021, 96 patients with lung cancer were selected from the Cardiothoracic Surgery Department of Suzhou Municipal Hospital. They were randomly divided into conventional group and precision group with 48 patients each. The conventional group was treated with conventional thoracoscope, and the precision group was treated with precise resection of lung cancer by thoracoscope. The general condition of operation, surgical segmental resection distribution, oncological efficacy, pulmonary function [carbon monoxide diffusion capacity(DLCO), forced expiratory volume in one second(FEV1), forced vital capacity(FVC)], complications, 1-year survival rate and recurrence rate after operation were compared between the two groups.Results Compared with the conventional group, the operation time and postoperative hospital stay in the precision group were shortened(t/P=10.284/<0.001, 4.240/<0.001). There was no significant difference in the amount of bleeding during the operation, the amount of drainage after the operation, the time of placing the tube after the operation, the anatomical resection of the right upper lung, the right lower lung, the left upper lung, and the left lower lung segments, the number of lymph node dissection stations, the number of lymph node dissection, and the width of the surgical margin(P>0.05). Compared with that before operation, DLCO, FEV1, FVC in both groups decreased 1 month after operation, and increased 3 months after operation, but lower than that before operation(P<0.01). The decrease in precision group 1 month after operation was lower than that in conventional group, and the increase in precision group 3 months after operation was greater than that in conventional group(t/P=2.950/0.004,3.862/<0.001,3.848/<0.001,3.550/0.001,2.837/0.006,2.950/0.004). The complication rate in the precision group was 4.17%(2/48), which had no significant difference compared with 6.25%(3/48) in the conventional group(P>0.05). There was no significant difference in Kaplan-Meier survival curve and recurrence rate between the two groups 1 year after operation(P>0.05). Conclusion Thoracoscopic lung cancer precise resection strategy has advantages in inter segment plane recognition and dissection of target pulmonary segment blood vessels, which can shorten the operation time, accelerate the patient's recovery, maximize the preservation of lung function, and make lung segment resection more accurate.
Establishment of prognostic nomogram for patients with gastrointestinal pancreatic neuroendocrine tumors with liver metastasis
Objective To analyze the prognostic factors of patients with gastrointestinal pancreatic neuroendocrine tumor(GEP-NEN) with liver metastasis, and establish an effective nomogram model. Methods Collect the clinical information of GEP-NEN patients with liver metastasis from 2010 to 2018 in the National Cancer Institute Surveillance, Epidemiology and End Results(SEER) database. Based on the independent prognostic factors screened by COX proportional hazard regression model, an nomograph was constructed to predict the 1, 3, and 5 year cancer specific survival(CSS) of patients, and the differentiation and calibration of the model were evaluated. Results 1 154 patients with liver metastasis from GEP-NEN were enrolled, including 808 in the modeling group and 346 in the validation group. COX multivariate analysis showed that age ≥ 59 years, poorly differentiated and undifferentiated, N1 and N2 stage were independent risk factors for prognosis [HR(95%CI)=1.84(1.51-2.24), 4.80(3.59-6.43), 3.29(2.30-4.70), 1.37(1.09-1.72), 3.16(1.91-5.22)]. Primary tumors located in the small intestine and pancreas and primary focus surgery were independent protective factors [HR(95%CI)=0.38(0.23-0.63),0.66(0.44-0.99),0.46(0.35-0.60)].The consistency indexes of the modeling group and the validation group were 0.805(95%CI 0.755-0.846) and 0.814(95%CI 0.733-0.875), respectively. The area under the working curve of the subjects with 1, 3, and 5-year specific survival rates in the two groups were 0.900, 0.893, 0.853, and 0.879, 0.879, 0.856, respectively. The predicted survival rate of the model was in good consistency with the actual survival rate. Conclusion The patients with age<59 years, primary tumors of small intestine and pancreas, good differentiation, N0 staging, and primary focus surgery had a good prognosis. The nomogram model established by the above factors had a good predictive ability for the prognosis of patients with GEP-NEN liver metastasis.
Expression of miR-452-5p and SOX7 in esophageal carcinoma and their relationship with pathological parameters and prognosis
Objective To study the expression of microRNA-452-5p(miR-452-5p) and SRY box related gene 7(SOX7) in esophageal carcinoma and their relationship with clinicopathological parameters and prognosis.Methods From January 2018 to January 2019, 103 patients with esophageal cancer diagnosed and treated by the Department of Oncology and Hematology of Leshan People's Hospital in Sichuan Province were selected as the study subjects. The expression of miR-452-5p and SOX7 mRNA in cancer and adjacent tissues was detected by real-time fluorescent quantitative PCR. Pearson correlation analysis was used to analyze the correlation between miR-452-5p and SOX7 mRNA expression. To analyze the relationship between the expression of miR-452-5p and SOX7 mRNA and clinicopathological features in cancer tissues. Kaplan Meier analyzed the effect of miR-452-5p and SOX7 mRNA expression on survival and prognosis of esophageal cancer patients. Univariate and multivariate COX regression analysis of risk factors affecting the prognosis of esophageal cancer. Results The expression of miR-452-5p in cancer tissues was higher than that in adjacent tissues(t=52.041,P<0.001), and the expression of SOX7 mRNA was lower than that in adjacent tissues(t=27.111,P<0.001). Pearson correlation analysis showed that there was a significant negative correlation between miR-452-5p and SOX7 mRNA expression(r=-0.504,P<0.001). The expression of miR-452-5p in stage Ⅲ, poorly differentiated and lymph node metastatic tumors was significantly higher than that in stage I-II, highly differentiated and non lymph node metastatic tumors(t=33.232, 18.003, 35.236, all P<0.001), while the expression of SOX7 mRNA was lower than that in stage Ⅰ-Ⅱ, highly differentiated and non lymph node metastatic tumors(t=21.805, 15.368, 33.543, all P<0.001). The median survival time of patients with high miR-452-5p expression was lower than that of patients with low miR-452-5p expression(26.15 vs.31.22 months, χ2=3.967,P=0.046), the 3-year overall survival rate was lower than that of patients with low expression(24.53% vs. 60.00%,χ2=5.093,P=0.024); The median survival time of patients with low expression of SOX7 mRNA was lower than that of patients with high expression of SOX7 mRNA(27.47 vs. 32.40 months, χ2=3.941,P=0.047), the 3-year overall survival rate was lower than that of patients with high expression(23.53% vs. 59.62%,χ2=5.285,P=0.022).Stage Ⅲ, low differentiation, lymph node metastasis, and high expression of miR-452-5p are independent risk factors affecting the prognosis of esophageal cancer [HR(95%CI)=1.520(1.176-1.966), 1.405(1.139-1.733), 1.929(1.229-3.028), 1.974(1.250-3.116)]. High expression of SOX7 mRNA is an independent protective factor [HR(95% CI)=0.575(0.397-0.832)].Conclusion The increased expression of miR-452-5p and decreased expression of SOX7 mRNA in esophageal cancer are related to tumor stage, differentiation and lymph node metastasis, and are new tumor markers related to prognosis of esophageal cancer.
Expression of lncRNA-SOX2OT and miR-122-5p in hepatocellular carcinoma and their relationship with pathological parameters and prognosis
Objective To analyze the expression of long chain non coding RNA-SRY box transcription factor 2 overlapping transcripts(lncRNA-SOX2OT) and microRNA-122-5p(miR-122-5p) in hepatocellular carcinoma(HCC) and their relationship with pathological parameters and prognosis. Methods From September 2017 to December 2018, 112 HCC patients were selected from Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine/Nanjing Second Hospital Cancer and Vascular Disease Intervention Department. RT-qPCR was used to detect the expression of lncRNA-SOX2OT and miR-122-5p in HCC and adjacent tissues. Pearson correlation analysis was used to analyze the correlation between the expression of lncRNA SOX2OT and miR-122-5p in HCC tissues, and to analyze the differences between them in different clinical/pathological parameters. Kaplan Meier survival curve was used to analyze the prognosis of patients with different expression of lncRNA SOX2OT and miR-122-5p. Results The expression of lncRNA-SOX2OT in HCC was higher than that in adjacent tissues, and the expression of miR-122-5p was lower than that in adjacent tissues(t=21.258, 20.475,P<0.001). There was a negative correlation between lncRNA-SOX2OT and miR-122-5p expression in HCC tissues(r=-0.771,P<0.001). The expression of lncRNA-SOX2OT in HCC tissues of patients with Child Pugh grade B-C, Barcelona clinical liver cancer(BCLC) stage late, and lymph node metastasis was higher than that of patients with Child Pugh grade A, BCLC stage very early to middle, and no lymph node metastasis(t/P=2.482/0.015, 2.728/0.007, 3.408/0.001), while the expression of miR-122-5p was lower than that of patients with Child Pugh grade A, BCLC stage very early to middle No lymph node metastasis [t(U)/P=2.514/0.013, 2.621/0.009, 3.078/0.002]. After 3 years of follow-up, the overall survival rate of 112 HCC patients was 67.86%(76/112). Kaplan Meier survival curve analysis showed that the overall survival rate of the high expression group of lncRNA SOX2OT was lower than that of the low expression group of lncRNA SOX2OT(χ2=11.176,P<0.001), the overall survival rate of miR-122-5p high expression group was higher than that of miR-122-5p low expression group(χ2=10.744,P<0.001). Conclusion The high expression of lncRNA-SOX2OT and the low expression of miR-122-5p in HCC tissues are related to Child Pugh grade, BCLC stage, lymph node metastasis and prognosis, which may become prognostic indicators of HCC.