Objective To investigate the prognosis of sepesis patients whose timing of hemopurification therapy was classified according to kidney disease:improving global outcomes acute kidney injury (KDIGO AKI) classification.Methods The clinic data of sepsis patients,who were treated with hemopurification therapy in Xiangya Hospital intensive care unit (ICU) during January 1,2014 to June 1,2014,were retrospectively analyzed.According to KGIDO AKI classification as their timing of hemopurification therapy,103 patients were divided to 2 groups,AKI Ⅰ group (n =34),AKI Ⅱ,Ⅲ group (n =69).Acute physiology and chronic health evaluation Ⅱ (APACHE-Ⅱ),sequential organ failure assessment (SOFA),rate of multiple organ injury 7-,28-,90-days mortality rate of 2 groups were analyzed.For 90 days survivors,the length of ICU stay,hospital stay,the frequency and time of hemopurification were analyzed,respectively.Results APACHE-Ⅱ,SOFA of KDIGO AKI Ⅰ group was less than KDIGO AKI Ⅱ,Ⅲ group.KDIGO AKI I group was less on rate of 3 and ≥4 organ injury than KDIGO AKI Ⅱ,Ⅲ group.7-,28-,90-days mortality rate of KDIGO AKI I group were less than AKI Ⅱ,Ⅲ group.In 90 days survivors,length of ICU stay,hospital stay,frequency and time of hemopurification of KDIGO AKI Ⅰ group were less than AKI Ⅱ,Ⅲ group.Conclusions KDIGO AKI classification is an effective indicator to sepsis patients for hemopurification therapy.Compared to KDIGO AKI Ⅱ,Ⅲ,sepsis patients with KDIGO AKI Ⅰ were less severity and multiple organ injuries.To start hemopurification during AKI Ⅰ,it could decrease mortality rate,length of ICU stay,hospital stay,and frequency and time of hemopurification therapy.

Objective To evaluate the changes and clinical significance of the serum level of homocysteine (Hcy) in esophageal cancer patients before and after surgery.Methods The serum Hcy concentrations of 168 patients with esophageal cancer and 50 healthy individuals were measured by enzymatic cycling.Results Total Hcy levels were significantly raised in patients group when compared with the levels in control group [(19.6±6.1) μmol/L vs (13.0±2.3) μmol/L,P =0.001].Hcy levels were significantly lower in postoperativepatients groups compared with preoperativegroup [(17.0±8.5),(15.8±6.4),(12.8±5.6) μmol/L vs (20.6±9.1) μmol/L,all P ＜ 0.05].Also,Hcy levels in patients with esophageal cancer were significantly higher than in the tumor length＞ 5cm group and the ＜3 cm,3-5 cm group [(23.6±9.6) μmol/L vs (18.1±6.3),(19.6±6.6) μmol/L,P =0.036,P =0.021].Compared with other T stage groups,significantly higher level of Hcy was found in T4 stage group [(29.5±1.7) μmol/L vs (18.5±6.9),(18.8±8.0),(20.6±8.8) μmol/L,all P ＜ 0.001].There was no significant difference between the mean Hcy concentrations of the node-positive and nodenegative group [(20.2±9.3) μmol/L vs (20.3±7.6) μmol/L,P =0.897].Compared with negative lymphaugial tumor-cells thrombus group,positive group had low Hcy level [(16.7±3.4) μmol/L vs (21.1±8.9) μmol/L,P =0.007].Conclusion These results showed that serum Hcy levels play important roles in the development of esophageal cancer.

Objective To investigate the diagnostic value of combined examination of homocysteine (Hcy) and CEA for male patients with gastric cardia cancer.Methods Serum concentration of Hcy,CEA,CA199,CA724,CA242 and TPS in 54 male patients with gastric cardia cancer and in 30 healthy men were measured.The diagnostic efficacy was analyzed between the combination of Hcy,CEA and the combination of Hcy,CEA,CA199,CA724,CA242,TPS.Results Total Hcy,CEA levels were significantly increased in patients group compared with control group ((20.3±9.2) μmol/L vs (13.7±3.1) μmol/L,(7.8±3.5) μg/L vs (1.6±1.2) μg/L,P ＜ 0.05).The sensitivity,specificity and accuracy of the combination of CEA,CA199,CA724,CA242 and TPS were 73.6 ％,64.5 ％ and 70.2 ％ respectively,while those of the combination of Hcy,CEA were 92.5 ％,64.5 ％ and 82.1％,respectively.There was significant difference between the combination of Hcy,CEA and the combination of CEA,CA199,CA724,CA242 and TPS (P ＜ 0.05).Conclusion Combined detection of Hcy and CEA is helpful for diagnosis in male patients with gastric cardia cancer.

Objective To evaluate the changes and clinical significance ot the serum levels of homocysteine (Hcy) in gastric cardia cancer patients before and after surgery.Methods Serum Hcy concentrations of 102 patients with gastric cardia cancer (including 69 case of males) and 50 healthy human were measured by enzymatic cycling assay.Results Total Hcy levels were significantly increased in male patient group compared with the levels in control group (t =5.143,P =0.001).Hcy levels were significantly lower in postoperative group compared with preoperative group [(17.08±5.31) μmol/L vs (20.34±9.26) μmol/L,(14.07±4.87) μmol/L vs (20.34±9.26) μmol/L,P ＜ 0.05].Compared with Ⅳ stage group and other TNM stage groups,significantly lower levels of Hcy were detected in patients with gastric cardia cancer (t =2.306,3.285,P =0.030,0.002).Hcy levels in patients with gastric cardia cancer were also significantly higher than those in the tumor length ＜ 3 cm,3-5 cm and ＞ 5 cm groups (t =2.461,2.147,P =0.017,0.038).Multiple logistic regression analysis indicated a statistically significant association between serum Hcy concentration and gastric cardia cancer incidence (OR =1.136,95 ％ CI 1.010-1.278,P =0.033).Increasing serum Hcy levels were significantly associated with a decreasing risk of metastatic lymph node (OR =0.865,P =0.010).Conclusion Serum Hcy levels are directly associated with risk of male patients with gastric cardia cancer,and play important roles in the development of gastric cardia cancer.

Objective To investigate the diagnosis value of homocysteine (Hcy) combined with carcinoembryonic antigen (CEA) and squamous cell carcinoma (SCC) antigen for esophageal cancer.Methods The serum levels of Hcy,CEA,CA199,CA724,CA50 and SCC antigen in 163 patients with esophageal cancer and 49 healthy people were measured.The diagnosis efficacy between the combination of Hcy,CEA and SCC antigen and the combination of CEA,CA199,CA724,CA50 and SCC antigen was compared.Results The levels of Hcy,CEA and SCC antigen were significantly raised in patients group as compared with the levels in control group (all P ＜ 0.05).The area under the ROC curve of Hcy was 0.722 (95 ％ CI 0.633-0.811),CEA was 0.619 (95 ％ CI 0.533-0.704) and SCC antigen was 0.685 (95 ％ CI 0.608-0.762),respectively.There were no significant differences among the three area under the ROC curve.The sensitivity,specificity and accuracy of the combination of CEA,CA199,CA724,CA50,SCC antigen were 69.9 ％,59.2 ％ and 67.5 ％,respectively,but the sensitivity,specificity and accuracy of the combination of Hcy,CEA,SCC antigen were 96.3 ％,69.4 ％ and 90.1％,respectively.There was significant difference between the combination of Hcy,CEA,SCC antigen and the combination of CEA,CA199,CA724,CA50,SCC antigen (P ＜ 0.05).Conclusion The combination of Hcy,CEA,SCC antigen is helpful to determine the diagnosis and efficacy of esophageal cancer.

Objectiveto investigate serum leptin concentration and lipdid levels in patients with esophageal squamous cell carcinoma and their clinical significance. MethodsBlood samples were collected from 47 patients with esophageal cancer, 20 healthy control subjects. Serum leptin was measured by ELISA and serum lipids was measured by biochemistry auto-analyzer. ResultsThe serum leptin concentration and LP α levels in patients group were significantly higher than those in control group[(13.09±5.94) ng/ml vs (7.584±4.15) ng/ml,(216.50±752.52) ng/ml vs(87.85±10.73) mg/L](P=0.001).However,the TG concentration was significantly lower than control group [(1.23±0.46) mmol/L vs (1.58±0.07) mmol/L]( P=0.001 ).Multiple logistic regression analysis revealed statistically significant association between serum leptin levels and esophageal squamous cell carcinoma incident(ORLeptm =1.442,95％ CI 1.094-1.848). ConclusionThe increased serum leptin levels maybe the risk factors of esophageal cancer,elevated LP α levels in patients might be a compensatory reactions.

Objective To investigate the effect of tumor length and number of positive lymph nodes and the ratio of positive lymph nodes on survival in patients with esophageal squamous cell carcinoma.Methods From July 1995 to July 2005, a total of 6,691 resected lymph nodes were obtained from 526patients who underwent curative resection of the primary tumour with systematic lymphadenectomy. The survivals were analysed by life tables and Kaplan-Meier methods. Results Among patients with regional disease, the number of positive lymph nodes (＞3) was related to an increasing risk. The proportion of positive lymph nodes compared with the number of lymph nodes dissected (20 %) conferred an increased risk. The tumor length (≤5 cm, 5 cm ＜ length ＜ 7 cm, ＞7 cm) was related to an increasing risk (84.74 %, 47.79 %,36.90 %, 35.52 %; 73.41%, 46.29 %, 23.87 %, 20.64 %; 64.44 %, 13.92 %, 0, 0). Conclusion Tumor length,the number of positive lymph nodes, and the ratio of positive lymph nodes are important prognostic factors for survival in patients with esophageal carcinoma. The PTNM classification system for patients with esophageal carcinoma might consider adding number of positive lymph nodes as an important prognostic factor.

Objective To analyze the prognostic factors of patients with adenocarcinoma of gastroesophageal junction (AGEJ) after radical resection. Methods In this retrospective study, 269 patients with AGEJ who underwent curative resection from March 2004 to June 2007 were enrolled.The survival curve was drawn by Kaplan-Meier method and the survival analysis was done by Log-rank test. Univariate and multivariate analyses of the prognostic factors of AGEJ were made by Cox model. Results The overall 5-year survival rate of 269 patients was 25.0 % with the median survival time of 22 months.The Siewert type and the number of positive lymph nodes could influence the survival rate (both P < 0.05). Among the 269 patients, 216 (80.3 %) were Siewert Ⅱ type, their median survival time was 30 and 12 months in the thoracic surgery group and the laparotomy group when the tumor diameter was 3-7 cm, the difference was statistically significant (χ2= 5.036, P= 0.025). Univariate analysis showed that tumor diameter, pT, pN, operation time, age and sex were significantly associated with survival rate (all P < 0.05). Cox multivariate analysis showed that patients with a more advanced tumor size suffered from a poorer prognosis (P< 0.05). The risk of postoperative death in patients with lymph node metastasis was 1.854 times that of patients without lymph node metastasis. Conclusions Patients with AGEJ are predominantly Siewert Ⅱ type, the transthoracic approach or thoracoabdominal approach are reasonable selections for these patients. Tumor diameter and pN are independent prognostic factors of AGEJ patients.

OBJECTIVETo investigate the significance of NADPH quinine oxidoreductase 1 (NQO1) protein overexpression on prognostic evaluation of head and neck squamous cell carcinoma (HNSCC).

METHODSNQO1 protein was detected in 162 of HNSCC, 45 cases of adjacent nontumor tissues and 26 samples of normal head and neck epithelia using EnVision immunohistochemical. Correlation between NQO1 overexpression and patients prognosis was also analyzed.

RESULTSThe positive rate and strongly positive rate of NQO1 protein were 84.0% (136/162) and 69.8% (113/162) in HNSCC, respectively, and both of which were significantly higher than either those in adjacent nontumor tissues and normal head and neck epithelia (both P < 0.01). NQO1 expression was significantly correlated with the clinical stage, pT and chemoradiotherapy of HNSCC (P < 0.01). Kaplan-Meier survival analysis showed that overall survival and disease-free survival rates were significantly higher in HNSCC patients with high level NQO1 expression than that those with low level of NQO1 expression (Log-rank = 6.625 , P = 0.010;Log-rank = 6.234 , P = 0.013). Additional analysis by Cox proportional hazard regression model showed that high level of NQO1 expression was an independent hazard predictor for overall survival of patients with HNSCC (Wald = 6.626, P = 0.008).

CONCLUSIONSNQO1 expression level is closely correlated with the progression and prognosis of patients with HNSCC. High level of NQO1 expression may be used as an important indicator for patients with poor prognostic HNSCC.

Breast ; enzymology ; Carcinoma, Squamous Cell ; enzymology ; mortality ; pathology ; Disease-Free Survival ; Female ; Head and Neck Neoplasms ; enzymology ; mortality ; pathology ; Humans ; Kaplan-Meier Estimate ; NAD(P)H Dehydrogenase (Quinone) ; metabolism ; NADH, NADPH Oxidoreductases ; metabolism ; Prognosis ; Proportional Hazards Models

Objective: To establish a triple-color pseudovirion-based neutralization assay (PBNA) and evaluate its capability of detecting immunogenicity of the sera generated by the immunization of HPV 9-valent vaccine. Methods: HPV pseudovirus (PsVs) 6/11/16/18/31/33/45/52/58 with the encapsidated fluorescence expressing red fluorescent plasmid N31-MCHREEY, green fluorescent N31-EGFP or blue fluorescent N31-mTagBFP were generated. The concentration of HPV PsVs and the infection titers of HPV PsVs were detected by double-antibody sandwich ELISA and TCID₅₀, respectively. The single- and triple color HPV 16/33/45 PsVs were used to detect the neutralization titers of mice sera immunized with HPV 9-valent vaccine and confirmed the accuracy and specificity of the triple-color PBNAs. Then, the single- and triple color HPV 6/11/18/31/33/45/52/58 PsVs were employed to detect the neutralization titers of cynomolgus macaques sera immunized with HPV 9-valent vaccine and determined whether the triple-color PBNAs could be applied to evaluate the immunogenicity of the sera generated by the immunization of HPV9-valent vaccine. Results: The concentration of HPV16 PsVs encapsulating green, red or blue fluorescent plasmid was 5.0 to 6.0 μg/ml and HPV6/11/18/31/33/45/52/59 triple-color HPV PsVs was about 1.0 to 3.0 μg/ml. 9 types HPV PsVs containing EGFP, Mcherry or mTagBFP reporter plasmid were obtained and the concentration can meet the need of neutralization detection. 9 types single-color fluorescent HPV PsVs had similar infectivity against 293FT cells with the infection titer values between 1×10⁴ and 1×10⁵. The results of PBNAs showed that there was no significant difference in the anti-HPV neutralization titers of mice sera induced by HPV 9-valent vaccine between single-color and triple-color HPV16/33/45 PsVs (P>0.05). Similarly, there was also no significant difference in the anti-HPV neutralization titers of cynomolgus macaques sera induced by HPV 9-valent vaccine between single-color and triple-color HPV6/11/18/31/33/45/52/58 PsVs (P>0.05). Conclusion We successfully established the triple-color PBNAs and verified the accuracy and specificity of triple-color PBNAs consistent with single-color PBNAs. The triple-color PBNAs can be applied to evaluate the immunogenicity of HPV 9-valent vaccine's immune serum.