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《YiNanBing ZaZhi》2023 Vol.22,No.1
  • Construction and validation of risk prediction model for autophagy related genes in oral squamous cell carcinoma based on TCGA
    Author:Wang Jinhang* ,Peng Shixiong,Zhao Jianguang,Chen Yanping,Cui Zifeng. keyword:Oral squamous cell carcinoma; Autophagy-related genes; Risk prediction model; Prognosis;
    Objective To construct an autophagy related gene(ARG) risk prediction model for oral squamous cell carcinoma(OSCC) using the cancer genome atlas(TCGA) database. Methods Screening ARG differentially expressed in OSCC based on TCGA database. The single factor Cox analysis, Lasso regression analysis and multi factor Cox analysis were conducted to construct the ARG risk prediction model. The ARG risk prediction model was divided into high and low risk groups according to the median of the model risk score(RS). The survival difference between groups was evaluated by Kaplan Meier. Univariate and multivariate Cox analysis examined the role of the model in predicting prognosis, the accuracy of the model was evaluated by the receiver operating characteristic curve(ROC), and finally the correlation between the model and clinical pathological characteristics was analyzed. Western blot was used to verify the expression of gene BAK1 in OSCC. Results A total of 37 differentially expressed ARGs were screened by OSCC(FDR<0.05, logfc="">1). Single factor Cox analysis, Lasso regression analysis and multivariate Cox analysis screened FADD, NKX2-3, and BAK1 as prognostic related differences to express ARG for the construction of risk prediction model, that is, RS=(1.558 5×FADD)+(-0.557 8 × NKX2-3)+(1.547 1 × BAK1). Kaplan-Meier survival analysis showed that the 5-year survival rate of high-risk group was lower than that of low-risk group(P<0.001). Cox analysis of single factor and multiple factors showed that the predictive model was effective and independent of other clinical factors(P<0.001). The ROC curve results showed that the area under the curve for diagnosing the prognosis of OSCC was 0.614. The RS of the model was increased in higher T stage and older age(P<0.05). Western blot results showed that the expression of BAK1 protein in OSCC cancer tissues was higher than that in adjacent tissues(t=3.197, P=0.033). Conclusion The risk prediction model based on FADD, NKX2-3, BAK1 and other three ARGs can be used as a biomarker to predict the prognosis of OSCC patients, which is helpful for individualized diagnosis and treatment of patients with different risks.
  • The efficacy and safety of double plasma exchange in the treatment of severe lupus nephritis with acute renal injury
    Author:Li Xiaoying,Yang Dandan,Huang Hui,Zhu Zhenxi,Wang Yingxiu keyword:Lupus nephritis; Acute kidney injury; Double plasma exchange; Renal function; Therapeutic effect;
    Objective To investigate the efficacy and safety of double plasma exchange in the treatment of severe lupus nephritis(LN) with acute renal injury. Methods From January 2017 to June 2021, 60 patients with severe LN combined with acute renal injury admitted by the Rheumatology and Immunization Department of Guangxi Baise People's Hospital were selected as the research objects, and were divided into the control group and the observation group according to the random number table method, with 30 cases in each group. Both groups were given conventional comprehensive treatment. On this basis, the control group was given immune preparation mycophenolate mofetil, and the observation group was given immune preparation mycophenolate mofetil combined with double plasma exchange. The disease activity index(SLEDAI), erythrocyte sedimentation rate(ESR), immunological indexes(anti double stranded DNA(ds-DNA), antinuclear antibody(ANA) titer, complement C3, complement C4), renal function(serum urea nitrogen(BUN), serum creatinine(SCr), 24h urine protein, urine red blood cell), coagulation function [platelet, fibrinogen(Fib), prothrombin time(PT) Activated partial thromboplastin time(APTT)], inflammatory indicators [interleukin-6(IL-6), C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), IL-1], evaluate the clinical efficacy and observe the occurrence of adverse reactions.Results There was no significant difference in the total remission rate between the observation group and the control group(96.67% vs.80.00%, P>0.05). After 2 weeks of treatment, SLEDAI score and ESR in the observation group were lower than those in the control group(t/P=5.214/< 0.001, 3.989/< 0.001). The titers of ds DNA and anti-ANA were lower than those in the control group(t/P=7.102/< 0.001, 4.857/< 0.001), while the complement C3 and C4 were higher than those in the control group(t/P=3.657/< 0.001, 4.102/< 0.001). SCr, BUN, 24h urine protein and urinary red blood cells were lower than those in the control group(t/P=6.213/< 0.001, 5.039/< 0.001, 3.574/< 0.001, 4.321/< 0.001). Fib was lower than the control group(t/P=3.345/0.001), PT and APTT were higher than the control group(t/P=2.635/0.011, 2.201/0.032). Serum IL-6, CRP, TNF-α, IL-1 in the control group was lower than that in the control group(t/P=4.717/< 0.001, 4.305/< 0.001, 2.202/0.032, 6.015/< 0.001). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Hemodialysis combined with double plasma exchange in the treatment of LN patients with acute kidney injury has significant effects in renal function, immunity, inflammation, coagulation function, and this regimen will not significantly increase the adverse reactions of patients, which can ensure the safety during treatment.
  • Relationship between portal vein thrombosis in liver cirrhosis and non-selective β receptor blockers and its risk fac- tors
    Author:Chen Jia* ,Xiao Xiao,Wan Xiaoqiang,Zheng Wei. keyword:Liver cirrhosis; Portal vein thrombosis; Non selective beta blockers; Risk factors;
    Objective To analyze the relationship between portal vein thrombosis(PVT) in liver cirrhosis and non-selective β receptor blockers(NSBB) and the risk factors of PVT formation and prognosis. Methods From July 2016 to October 2019, 84 patients with liver cirrhosis who first diagnosed PVT in the Affiliated Central Hospital of Chongqing University were collected as the PVT group, and 90 patients with liver cirrhosis without PVT in the same period were selected as the control group. Statistics were made on the use of NSBB before and after hospitalization in the two groups, and the clinical data and prognosis of the two groups were compared. Multifactor Logistic regression was used to analyze the risk factors of PVT formation. Results There was no significant difference in the use of NSBB between the two groups before hospitalization(P>0.05), but the use of NSBB in PVT group was higher than that in the control group after hospitalization(χ2/P=4.372/0.037). The proportion of patients with abdominal surgery history, splenectomy and previous endoscopic treatment in PVT group was higher than that in control group(χ2/P=5.224/0.022, 17.154/< 0.001, 7.992/0.005), and the hemoglobin level was lower than that of the control group(t/P=3.360/0.001). Multivariate logistic regression analysis showed that splenectomy and previous endoscopic treatment were independent risk factors for PVT formation [OR(95% CI)=12.483(2.819-55.284), 2.753(1.319-5.747)], and high hemoglobin was a protective factor [OR(95% CI)=0.985(0.975-0.995)]. The proportion of ascites and gastrointestinal bleeding in PVT group was higher than that in control group(χ2/P=10.618/0.001, 21.965/<0.001), but="" there="" was="" no="" significant="" difference="" in="" mortality="" between="" the="" two="" p="">0.05). Conclusion The use of NSBB is the result of the progress of liver cirrhosis and the increase of portal vein pressure, not the cause of PVT. Splenectomy, previous endoscopic treatment and low hemoglobin are high risk factors for PVT. PVT can increase the risk of ascites and gastrointestinal bleeding.
  • Clinical and pathological characteristics of idiopathic inflammatory myopathy with positive anti Mi-2 antibody: re- port of 7 cases and review of literature
    Author:Lin Ying,Chen Juan,Liu Mengyang,Shi Qiang. keyword: Idiopathic inflammatory myopathy; Anti-Mi-2 antibody; Muscle biopsy; Clinical characteristic
    Objective To summarize the clinical and skeletal muscle pathological characteristics of patients with anti Mi-2 antibody positive idiopathic inflammatory myopathy (IIM). Methods The clinical data of 7 anti Mi-2 antibody positive IIM patients diagnosed and treated in the First Medical Center of the PLA General Hospital from January 1, 2019 to February 28, 2022 were collected for retrospective analysis, and the literature at home and abroad was reviewed. Results In 7 cases, proximal muscle weakness was more common, which could be accompanied by dysphagia, myalgia, arthralgia and muscular at- rophy. Severe rash occurred in 4 cases. Interstitial pneumonia (ILD) is rare, and may be accompanied by malignant tumor or hypothyroidism/vaccination history. The pathological changes of inflammatory myopathy can be seen in skeletal muscle pathol- ogy, which is consistent with the characteristics of perifascicular immunomyopathy (IMPP). Immunohistochemical staining showed positive expression of MHC-I muscle underwear and positive expression of anti myxovirus A protein (MxA) perifas- cicular muscle fiber membrane and muscle plasma. After 3 months of combined treatment with glucocorticoid and immuno- suppressant, the condition of 7 patients improved. Conclusion The clinical phenotypes of IIM patients with positive anti Mi- 2 antibody were mostly dermatomyositis (DM) classic rash, myalgia, myasthenia, etc. IMPP can be seen in muscle biopsy, with less ILD, and may be associated with immune disease. Steroid combined with immunosuppressive agents had a better response.
  • Meta analysis of risk factors of cognitive impairment after stroke in Chinese population
    Author:Zhao Wannian* ,Jiao Shengxian,Jiao Qian,Li Shasha,Jia Yaqing,Wang Hebo keyword:Post-stroke cognitive impairment; Risk factors; Meta analysis
    Objective To systematically evaluate the risk factors of Chinese people with post stroke cognitive impair-ment (PSCI), so as to provide a reference for the establishment of PSCI risk prediction model. Methods We searched Wan-fang Data, Weipu Journal Network, CNKI, PubMed, The Cochrane Library, and Embase databases from the establishment of the database to September 1, 2022, and used RevMan 5.4 and Stata 12.0 software for meta-analysis. Results A total of 34 arti-cles were included, including 12 365 subjects. Meta analysis showed that the incidence rate of PSCI in Chinese ischemic stroke population was 50% . Male (OR = 0.76, 95% CI 0.63 - 0.92), age (WMD = 5.44,95% CI 4.25 - 6.62), low education level (OR= 2.43, 95% CI 1.86 - 3.17), NIHSS score (WMD = 3.08, 95% CI 1.15 - 5.00), hypertension (OR = 1.61, 95% CI 1.37 - 1.89),diabetes (OR = 1.33, 95% CI 1.15 - 1.53), past history of stroke (OR = 2.73, 95% CI 1.83 - 4.08), glycosylated hemoglobin ≥6% (OR = 4.04, 95% CI 2.67 - 6.10) Low density lipoprotein cholesterol (WMD = 0.13, 95% CI 0.03 - 0.23), homocysteine WMD = 3.92, 95% CI 2.16 - 5.68), high-sensitivity C-reactive protein (WMD = 2.35, 95% CI 0.39 - 4.30), and cystatin C WMD = 0.22, 95% CI 0.09 - 0.34) were risk factors for PSCI patients in China (P < 0.05). Conclusion Multiple factors in-boratory indicators, control and treatment of combined diseases and other interventions.