1.Predictive value of combined detection of serum tumor markers for recurrence or metastasis of colon cancer after radical surgery
Yu ZHANG ; Xin LI ; Wen LUO ; Tingting NI ; Shisheng TAN
Chongqing Medicine 2015;(26):3616-3617,3621
Objective To explore the clinical application value of the expression levels of serum hypoxia induced factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),carcino-embryonic antigen(CEA)and CA125 in predicting the recurrence or metastasis of colon cancer after radical resection.Methods Totally 123 cases of colon cancer after radical surgery in our hospital from July 2009 to December 2013 were performed the retrospective analysis.The correlation between the serum markers levels with the recurrence or metastasis was dynamically analyzed.Results (1)The HIF-1αand CEA levels after operation in 123 cases of co-lon cancer were decreased significantly compared with before operation;(2)The HIF-1α,CEA and CA125 levels in 39 cases of re-currence or metastasis were significantly increased compared with those in 84 cases of non-recurrence or non-metastasis (P <0.05);(3)in 39 cases of recurrence or metastasis,the HIF-1α and CEA levels in recurrence or metastasis were increased signifi-cantly compared with those after the end of chemotherapy (P <0.05);(4)HIF-1αwas positively correlated to VEGF(P <0.05). Conclusion The serum levels of HIF-1αand CEA in the patients with colon cancer are positively correlated with recurrence or me-tastasis,the dynamically combined detection of serum markers has an important significance for predicting and early find recurrence or metastasis after radical operation in colon cancer.
2.Changes in coagulation activity and its clinical significance in elderly patients with primary microvascular angina pectoris
Qi HUANG ; Xiangqian SUI ; Ronghua LUO ; Shisheng WANG ; Qiang YAO ; Yuanhong WU ; Mingbin XIE
Chinese Journal of Geriatrics 2021;40(5):566-569
Objective:To investigate plasma levels of fibrinopeptide A(FPA)and platelet alpha-granule membrane glycoprotein 140(GMP-140), and to analyze the changes of coagulation activity in elderly patients with primary microvascular angina(PMVA).Methods:In this prospective case-control study, a total of 45 elderly patients(aged 60-80 years, 27 males and 18 females)admitted to our hospital from Jan.2019 to Dec.2020 were diagnosed as PMVA(as microvascular angina group)by clinical symptoms, electrocardiogram, dynamic electrocardiogram and coronary angiography.Forty-three age-and sex-matched elderly subjects who took a medical check-up and had no primary microvascular angina were included as the control group.Plasma levels of FPA, GMP-140 and high-sensitivity C-reactive protein were determined.The levels of systolic blood pressure, diastolic blood pressure, platelet, fasting blood glucose, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein, uric acid, renal function and liver function were detected.Results:The FPA level was higher in the PMVA group than in the control group[(430.32±364.05)μg/L vs.(263.73± 118.29)μg/L, t=2.913, P<0.01]. There was no difference in GMP-140 level between the PMVA group and the control group[(5.78±3.92)μg/L vs.(6.95±1.91)μg/L, t=-1.790, P>0.05]. The high-sensitivity C-reactive protein level was higher in the PMVA group than in the control group[(3.33±5.70)mg/L vs.(0.81±0.86)mg/L, t=2.927, P<0.01]. Conclusions:Compared with the control group, the FPA level is significantly increased with elevated coagulation activity in patients with primary microvascular angina.The increased inflammatory state in the PMVA group might promote the occurrence and development of microvascular angina, but whether the inflammatory state promotes the enhancement of coagulation activity needs further study to confirm.
3.Investigation of the influence of different etiologies on serum level of carbohydrate antigen 125 in elderly patients with heart failure
Qi HUANG ; Mingbin XIE ; Min WANG ; Zhengming XU ; Dean PEI ; Qiang YAO ; Ronghua LUO ; Shien HUANG ; Shisheng WANG
Chinese Journal of Geriatrics 2011;30(6):464-466
Objective To investigate the effect of different etiology on the serum level of carbohydrate antigen 125 (CA125) in elderly patients with chronic congestive heart failure (CHF), and to assess any correlation of CA125 with serum level of B-type natriuretic peptide (BNP). Methods The 155 aged patients with New York Heart Association (NYHA) class Ⅲ or Ⅳ were enrolled and grouped into four reasons of hypertension, coronary heart disease (CHD), cardiomyopathy and other reasons, and 25 healthy old persons as control.CA125 and BNP levels were measured by automatic chemiluminescent immunoassay and enzyme immunoradiometric assay, respectively. Results CA125 level in patients with CHF was (83.4±6.6)U/L for hypertension, (36.8±1.4)U/L for CHD, (38.1±1.6)U/L for cardiomyopathy and (38.4±1.4)U/L for other reasons, which significantly higher than for healthy controls [(14.3±1.15) U/L, P<0.05].Especially, CA125 level in hypertension group was notable higher than in other reasons of group (P<0.05), and was positively related to BNP level (r=0.67,P<0.05). Conclusions Serum CA125 level is a predictor for clinical pathogen of CHF.Therefore, it may be a useful additional marker for the evaluation of clinical treatment of these patients
4.Comparison of the therapeutic effect of preoperative and postoperative chemoradiotherapy for locally advanced rectal cancer
Chan CHENG ; Shan JIN ; Wen PENG ; Ying JIANG ; Xueying SI ; Wen LUO ; Tingting NI ; Shisheng TAN
Chongqing Medicine 2018;47(16):2173-2176,2180
Objective To compare the therapeutic effect of preoperative chemoradiotherapy or postoperative adjutant chemoradiotherapy for locally advanced rectal cancer.Methods The clinical data of 76 patients with locally advanced rectal cancer from 2011 to 2016 in Guizhou Provincial People's Hospital were retrospectively analysed.A total of 30 cases received preoperative chemoradiotherapy (group A),5 of them received concurrent chemoradiotherapy combined with bevacizumab target treatment.The other 46 cases (group B) were given post-operative adjutant chemoradiotherapy.Both group A and group B were treated with intensity-modulated radiation therapy (IMRT).The chemoradiotherapy regime was as follows:the median of target volume dose was 50.4 Gy (45.0-55.8 Gy);the median of chemotherapy sessions was 26 times (24-28 times).Capecitabine tablets (825 mg/m2,twice a day) were also given on the date of chemotherapy.The clinical data and follow-up results of all patients were compared between the two groups.Results The five-year disease free survival rates of group A and group B were 66.7% and 57.7%,respectively;and the five-year overall survival rates of group A and group B were 81.8% and 73.0%,respectively,no statistically significant difference was found between the two groups (P=0.599,0.489).The anus-preserving rates of patients with tumor below peritoneal reflection in group A and group B were 56.52% and 25.00%,there was statistically significant difference (P=0.045).In the group A,86.6 % patients resulted in down-staging,including 3 cases with complete pathologic response.Conclusion Preoperative chemotherapy could down tumor stage and improve rates of anal preservation and local control without increasing possibility of postoperative complications.Preoperative chemotherapy in combination with bevacizumab target treatment may be more effective in lowering tumor stage.
5.A case report of heat stroke with early severe brain edema
Tuoying WEN ; Shisheng LUO ; Liya PAN
Journal of Environmental and Occupational Medicine 2023;40(7):830-833
Heat stroke can be divided into two types: exertional and classic, mainly manifested as a clear history of exposure to hot temperature/high heat environment or intense physical activity in hot environment, core temperature exceeding 40 ℃, accompanied by central nervous system changes (altered consciousness, epilepsy, psychiatric symptoms, etc.) and multiple organ damage, including respiratory failure, impaired liver and kidney function, rhabdomyolysis, coagulation disorders, abdominal distension, and diarrhea. Its pathology may be manifested as organ endothelial cell damage, inflammatory response, extensive thrombosis, and bleeding tendency. The main treatment measures are cooling therapy, and when combined with other organ damage, organ support or replacement therapy should be carried out in time, including blood transfusion to improve coagulation function and blood purification therapy. Hyperbaric oxygen therapy may improve the prognosis of patients with ischemic hypoxic encephalopathy. We reported a case of a firefighter with sudden impaired consciousness and high fever during forest fire fighting. The patient was sent to a local hospital and his head computed tomography (CT) results showed unclear cerebral gyrus, suggesting severe cerebral edema, and finally diagnosed as heat stroke. After being transferred to Liuzhou Workers' Hospital, his condition continued to deteriorate and signs of multiple organ failure appeared. The patient's cerebral edema was reversed and further development of heat stroke was prevented through early cooling, sedation and anti-epilepsy, endotracheal intubation ventilator-assisted breathing, anti-infection, fluid resuscitation, infusion of fresh frozen plasma and platelets to improve coagulation function, immunomodulatory therapy, renal replacement therapy, and timely artificial liver therapy. Hyperbaric oxygen therapy was ordered during the rehabilitation phase, and the patient recovered well at discharge, leaving no obvious neurological sequelae. Its prognosis is much better than that predicted at admission.