1.The interval of rescue treatment does not affect the efficacy and safety of Helicobacter pylori eradication: A prospective multicenter observational study.
Minjuan LIN ; Junnan HU ; Jing LIU ; Juan WANG ; Zhongxue HAN ; Xiaohong WANG ; Zhenzhen ZHAI ; Yanan YU ; Wenjie YUAN ; Wen ZHANG ; Zhi WANG ; Qingzhou KONG ; Boshen LIN ; Yuming DING ; Meng WAN ; Wenlin ZHANG ; Miao DUAN ; Shuyan ZENG ; Yueyue LI ; Xiuli ZUO ; Yanqing LI
Chinese Medical Journal 2025;138(12):1439-1446
BACKGROUND:
The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections.
METHODS:
This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups.
RESULTS:
A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups.
CONCLUSION:
The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs.
REGISTRATION
ClinicalTrials.gov , NCT05173493.
Humans
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Helicobacter Infections/drug therapy*
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Helicobacter pylori/pathogenicity*
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Male
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Female
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Prospective Studies
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Middle Aged
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Anti-Bacterial Agents/adverse effects*
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Adult
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Aged
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Treatment Outcome
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Proton Pump Inhibitors/therapeutic use*
2.Discussion on mechanical ventilation strategies for an obese patient with H10N3 avian influenza complicated with severe acute respiratory distress syndrome.
Youling LI ; Zhouhua XIE ; Ping CEN ; Sheng LIU ; Ning LU ; Shiji TAN ; Yuming LU ; Jing WEI
Chinese Critical Care Medicine 2025;37(9):871-874
Avian influenza H10N3 is a type of avian influenza virus that can occasionally infect humans and cause severe pneumonia and acute respiratory distress syndrome (ARDS). On December 25, 2024, a 23-year-old obese female patient with H10N3 avian influenza complicated with severe ARDS was admitted to the Fourth People's Hospital of Nanning. The patient was transferred to our department due to "fever, cough, and shortness of breath for 13 days". Physical examination revealed moist rales in bilateral lungs. Chest imaging showed large areas of ground-glass opacity and consolidation in both lungs. Based on the patient's medical history, clinical manifestations, and laboratory findings, she was diagnosed with human infection of H10N3 avian influenza, severe pneumonia, and severe ARDS. Supported by mechanical ventilation and extracorporeal membrane oxygenation (ECMO), daily monitoring of airway peak pressure, plateau pressure (Pplat), driving pressure (ΔP), and lung compliance was performed to guide the adjustment of tidal volume (VT) and positive end-expiratory pressure (PEEP) during invasive mechanical ventilation. Medications including anti-avian influenza virus agents, antibacterial drugs, and antifungals were administered. Eventually, the patient's condition improved gradually, and she was successfully weaned from ECMO. No ventilator-induced lung injury (VILI) or multiple organ dysfunction syndrome (MODS) related to ARDS occurred during ECMO support. However, during the final stage of ventilator weaning after the restoration of spontaneous breathing, a right pneumothorax occurred. Closed thoracic drainage was performed, after which the ventilator was successfully discontinued. The patient was successfully transferred out of the intensive care unit (ICU), recovered fully, and was discharged from the hospital. In the invasive mechanical ventilation management of patients infected with H10N3 avian influenza complicated by ARDS, monitoring airway peak pressure, Pplat, ΔP, and assessing pulmonary compliance may facilitate more standardized management of such ARDS patients and help reduce VILI.
Humans
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Female
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Influenza, Human/complications*
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Respiratory Distress Syndrome/complications*
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Respiration, Artificial/methods*
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Obesity/complications*
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Young Adult
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Extracorporeal Membrane Oxygenation
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Influenza A virus
3.Comparison of diagnostic efficacy between 68Ga-PSMA-11 PET/CT and mpMRI for pelvic lymph node metastasis in prostate cancer patients with or without neoadjuvant endocrine therapy
Wenhui YANG ; Yuming JING ; Jingliang ZHANG ; Jianhua JIAO ; Chaochao CUI ; Jian CHEN ; Shikuan GUO ; Chunjuan TIAN ; Fei KANG ; Weijun QIN
Chinese Journal of Urology 2024;45(6):445-450
Objective:To compare the diagnostic efficacy of 68Ga-PSMA-11 PET/ CT and multi-parameter magnetic resonance imaging (mpMRI) for pelvic lymph node metastases in prostate cancer patients who received neoadjuvant endocrinology or not after initial diagnosis. Methods:Data of 52 patients with moderate and high-risk prostate cancer admitted to Xijing Hospital from February to October 2023, aged (65.8±6.6) years, preoperative prostate-specific antigen (PSA) 26.67 (13.09, 84.89) ng/ml, were retrospectively analyzed. Before operation, there were 28 cases of cT 2stage, 16 cases of cT 3 stage and 8 cases of cT 4 stage. There were 22 cases of cN 0 and 30 cases of cN 1. All patients underwent 68Ga-PSMA-11 PET/CT and mpMRI at the same time, and were diagnosed positive lymph nodes in 28 and 21 cases, respectively. Risk stratification were high risk in 45 cases, and medium risk in 7 cases. According to the preoperative endocrine treatment, they were divided into the newly diagnosed group without treatment (24 cases) and the endocrine treated group (28 cases), whose ages were (65.0±7.1) years and (66.8±6.1) years, respectively. Preoperative PSA was 26.17 (16.73, 61.18) ng/ml and 27.32 (11.94, 130.18) ng/ml, respectively. Gleason scores ≤7 were in 10 cases (41.7%) and 6 cases (21.4%), and Gleason scores >7 were in 14 cases (58.3%) and 22 cases (78.6%), respectively. There were 15 (62.5%) and 13 (46.4%) cases of cT 1-2 stage, and 9 (37.5%) and 15 (53.6%) cases of cT 3-4 stage, respectively. There were 16 (66.7%) and 6 (21.4%) cases of stage N 0, 8 (33.3%) and 22 (78.6%) cases of stage N 1, respectively. There were 22 (91.7%) and 20 (71.4%) cases of stage M 0, 2 (8.3%) and 8 (28.6%) cases of stage M 1, respectively. PET/CT diagnosis of lymph node positive was in 9 cases (37.5%) and 19 cases (67.9%), and mpMRI diagnosis of lymph node positive was in 5 cases (20.8%) and 16 cases (57.1%). The number of positive lymph nodes diagnosed by PET/CT was 13 (72.2%) and 47 (90.1%), and the number of positive lymph nodes diagnosed by mpMRI was 8 (44.4%) and 32 (61.5%). There was no significant difference ( P>0.05). All patients underwent radical prostatectomy as well as enlarged pelvic lymph node resection. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the two imaging examinations in the diagnosis of lymph node metastasis were compared according to the results of postoperative pathological examination of lymph nodes. Receiver operating characteristic (ROC) curve was used to compare the accuracy of the two imaging tests in the diagnosis of pelvic lymph node metastasis in the newly diagnosed untreated group and the endocrine treated group. Results:In this study, of 52 cases, 26 (50.0%) had positive lymph nodes by pathological examination. In this study, a total of 681 lymph nodes were dissected, with 70 lymph nodes (10.28%) being pathologically positive, and the positive rate of 26 patients was 17.99% (70/389). The PET/CT and mpMRI detection rates of 26 node-positive patients were 92.3% (24/26) and 57.7% (15/26), respectively. There were 9 (37.5%) and 17 (60.7%) lymph node positive patients in the untreated group and the endocrine therapy group, respectively. There were 320 and 361 lymph nodes were clear, with 18 (5.6%) and 52 (14.4%) positive lymph nodes, respectively. The detection rates of PET/CT and mpMRI were 88.89% (8/9) and 94.12% (16/17)in the untreated group, and 44.44% (4/9) and 64.71% (11/17)in the endocrine treated group, respectively. In the newly treated group, the area under the curve (AUC) of PET/CT and mpMRI for diagnosing positive lymph nodes were 0.911 and 0.689 ( P=0.027), the sensitivity were 88.9% and 44.4%, and the specificity were 93.3% and 93.3%, respectively. PPV were 88.9% and 80.0%, and NPV were 93.3% and 73.7%, respectively. In the endocrine therapy group, the AUC of PET/CT and mpMRI for lymph node positive diagnosis were 0.834 and 0.596 ( P=0.011), the sensitivity were 94.1% and 64.7%, the specificity were 72.7% and 54.5%, and the PPV were 84.2% and 68.8%, respectively. NPV were 88.9% and 50.0%, respectively. Conclusions:For prostate cancer patients, regardless of whether they receive neoadjuvant endocrine therapy, 68Ga-PSMA-11 PET/CT can accurately detect pelvic lymph node metastasis, and the diagnostic efficacy is significantly better than that of mpMRI.
4.Expression of DCBLD2 and MAP4K3 in Thyroid Cancer Tissue and Their Relationship with Clinico-pathological Features and Prognosis
Jiuting TAN ; Yuming FU ; Jing LIU ; Tiran ZHANG
Journal of Modern Laboratory Medicine 2024;39(2):34-38,67
Objective To investigate the expression of discoidin CUB and LCCL domain containing 2(DCBLD2)and mitogen activated protein kinase kinase kinase kinase 3(MAP4K3)in thyroid cancer and their relationship with clinico-pathological features and prognosis.Methods A total of 92 patients with thyroid cancer diagnosed and treated in Xinghua People's Hospital Affiliated to Yangzhou University from January 2016 to June 2020 were selected.Immunohistochemistry(IHC)was used to detect the expression of DCBLD2 and MAP4K3 in thyroid cancer tissues and adjacent tissues.The expression differences of DCBLD2 and MAP4K3 in thyroid cancer patients with different clinicopathological features were compared.Kaplan-Meier curve analysis was used to analyze differences in the progression-free survival prognosis of patients with different DCBLD2 and MAP4K3 expressions.Multivariate COX analysis was used to analyze the risk factors affecting the progression-free survival prognosis of thyroid cancer.Results The positive rates of DCBLD2(67.39%)and MAP4K3(65.22%)in thyroid cancer tissues were higher than those in adjacent tissues(5.43%,6.52%),and the differences were statistically significant(χ2=76.262,68.894,all P<0.05).The expression of DCBLD2 was positively correlated with MAP4K3(r=0.742,P<0.001).The positive rates of DCBLD2 and MAP4K3 in stage Ⅲ~Ⅳ(87.18%,84.62%)and lymph node metastatic cancer tissues(93.75%,90.63%)were higher than those in stage Ⅰ~Ⅱ(52.83%,50.94%)and non lymph node metastatic cancer tissues(53.33%,51.67%),with statistically significant differences(χ2=11.230~15.513,all P<0.05).The 3-year progression-free survival rates of DCBLD2-positive and DCBLD2-negative patients were 74.19%(46/62)and 93.33%(28/30),respectively.The 3-year progression-free survival rates of MAP4K3 positive and negative patients were 75.00%(45/60)and 90.63%(29/32),respectively.The 3-year cumulative progression-free survival rate of DCBLD2 positive group and MAP4K3 positive group was lower than that of DCBLD2 negative group and MAP4K3 negative group,and the differences were statistically significant(χ2=4.533,4.138,P=0.033,0.046).DCBLD2 positive(OR=1.659,P=0.001),MAP4K3 positive(OR=1.606,P=0.001),tumor TNM stage Ⅲ~Ⅳ(OR=1.766,P=0.001)and combined lymph node metastasis(OR=1.868,P=0.001)were independent risk factors for the progression-free survival prognosis of thyroid cancer patients.Conclusion The expressions of DCBLD2 and MAP4K3 were increased in thyroid cancer tissue.They are involved in the occurrence and development of thyroid cancer,which may help evaluate the progression-free survival prognosis of thyroid cancer patients.
5.Comparative analysis of domestic Octoparms and imported Celect inferior vena cava filter in interventional treatment of venous thromboembolism
Jinchang XIAO ; Qianxin HUANG ; Jing YANG ; Mingming JIANG ; Ning WEI ; Hongtao LIU ; Yanfeng CUI ; Yuming GU ; Maoheng ZU ; Hao XU ; Qingqiao ZHANG
Journal of Practical Radiology 2024;40(3):456-459,463
Objective To compare and analyze the application value of domestic Octoparms and imported Celect inferior vena cava filter(IVCF)in the interventional treatment of venous thromboembolism(VTE).Methods Forty patients with VTE were randomly divided into Octoparms group(experimental group)and Celect group(control group)according to the double-blinded method of the central random system.All the patients underwent filter placement,catheter-directed thrombolysis and filter retrieval.The primary end point was the success of filter placement and retrieval,and the secondary end point included indwelling complications such as the occurrence of pulmonary embolism(PE)and filter tilt and migration.Results Forty patients were enrolled in this study,22 patients and 18 patients were divided into the experimental group and the control group,respectively.Among them,11 cases were identified with right lower extremity deep vein thrombosis,29 cases with left lower extremity deep vein thrombosis,17 cases with PE,and 6 cases with inferior vena cava thrombosis.The success rate of IVCF placement was 100%in all participants.Immediately after filter place-ment,the angle of filter tilt was(3.8±2.3)° in the experimental group and(4.9±2.8)° in the control group(t=1.44,P=0.16).Filter retrieval was successful in 21 cases(21/22,95.5%)of the experimental group and 17 cases(17/18,95.5%)of the control group.There was no significant difference between the two groups(t=0.14,P=0.89).The mean indwelling time of filter was(8.0±2.1)days in the experimental group and(9.7±3.1)days in the control group(t=0.73,P=0.47).The angle of filter tilt was(5.3±3.4)° in the experimental group and(5.7±7.7)° in the control group(t=0.19,P=0.85).There was no significant difference for filter placement and retrieval between the two groups(t=0.48 and 2.00,P=0.06 and 0.64,respectively).There were no complications of filter migration,strut penetration or new PE in both groups.Conclusion The application value of domestic Octoparms and impor-ted Celect IVCF is similar in interventional treatment of VTE.
6.Mechanism of Taohong Siwutang Alleviating Myocardial Ischemia Reperfusion Injury in Ovariectomized Mice by Up-regulating Nrf2/HO-1 Signaling Pathway
Yuming YANG ; Ying ZHU ; Changyi LIU ; Jing CHENG ; Fei HE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(13):11-19
ObjectiveTo investigate the effect and mechanism of Taohong Siwutang (TSD) on myocardial ischemia reperfusion injury (MIRI) in ovariectomized (OVX) female mice. MethodAfter the OVX model of female mice was established, the estradiol (E2) level was detected by enzyme-linked immunosorbent assay (ELISA) to verify the model. Sixty OVX mice were randomly divided into six groups: Sham operation group, model group, low, medium, and high dose groups (9, 18, 36 g·kg-1) of TSD, and nuclear factor E2-related factor 2 (Nrf2) inhibitor group, with 10 mice in each group. The MIRI model was verified by a laser speckle flowmeter. The pathological changes in myocardial tissue were detected by 2,3, 5-triphenyltetrazolium chloride (TTC) and hematoxylin-eosin (HE) staining. Serum creatine kinase isoenzyme (CK-MB), cardiac troponin Ⅰ (CTnⅠ), malondialdehyde (MDA), superoxide dismutase (SOD), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels were detected by ELISA. The expression of Nrf2 and heme oxygenase-1 (HO-1) were observed by immunofluorescence staining. The expressions of Nrf2, HO-1, apoptotic B-cell lymphomato-2 (Bcl-2), Bcl-2 associated X protein (Bax), inflammatory cytokines interleukin-18 (IL-18), and interleukin-1β (IL-1β) were detected by Western blot. ResultCompared with the sham operation group, the serum levels of CK-MB, CTnⅠ, MDA, and IL-6 in the model group were increased (P<0.01), and the levels of SOD and IL-10 were decreased (P<0.01). The damage scores of TTC and HE staining in myocardial tissue were increased (P<0.01). The expressions of Nrf2 and HO-1 in myocardial tissue by immunofluorescence were decreased (P<0.01), and the protein expressions of Nrf2, HO-1, and Bcl-2 in myocardial tissue were decreased. The protein expressions of Bax, IL-18, and IL-1β were increased (P<0.01). Compared with the model group, serum levels of CK-MB, CTnⅠ, MDA, and IL-6 of TSD groups were significantly decreased (P<0.05, P<0.01), and SOD and IL-10 were significantly increased (P<0.05, P<0.01). TTC staining and HE staining damage scores of myocardial tissue were significantly decreased (P<0.01). The expressions of Nrf2 and HO-1 in myocardial tissue by immunofluorescence were increased (P<0.01). The protein expressions of Nrf2, HO-1, and Bcl-2 were significantly increased (P<0.05, P<0.01), and those of Bax, IL-18, and IL-1β were significantly decreased (P<0.05, P<0.01). The effect of the high dose group of TSD was the most significant. The serum levels of CK-MB, CTnⅠ, MDA, and IL-6 in the Nrf2 inhibitor group were significantly increased (P<0.05, P<0.01), and the levels of SOD and IL-10 were significantly decreased (P<0.05, P<0.01). The damage scores of TTC and HE staining in myocardial tissue were significantly increased (P<0.01). The expressions of Nrf2 and HO-1 in myocardial tissue by immunofluorescence were significantly decreased (P<0.01). The protein expressions of Nrf2, HO-1, and Bcl-2 in myocardial tissue were significantly decreased, and those of Bax, IL-18, and IL-1β were significantly increased (P<0.01). ConclusionTSD can alleviate MIRI in OVX mice, reduce oxidative stress response and the release of inflammatory factors, and inhibit apoptosis, playing a protective role in OVX mice with MIRI, which may be related to the activation of Nrf2/HO-1 signaling pathway.
7.Effects of microwave radiation on learning and memory and neurotransmitters in the hippocampus
Dan DU ; Mengjuan SHANG ; Jiajin LIN ; Xia MIAO ; Yuming YAN ; Shenglong XU ; Na SUN ; Jing LI
Chinese Journal of Radiological Health 2023;32(2):209-215
The central nervous system is one of the most sensitive targets of microwave radiation. Microwave radiation can affect spatial learning and memory and neural information transmission. The effects of microwave radiation on neurotransmitters in the hippocampus and the underlying mechanisms are still unclear. This paper reviews the effects of microwave radiation on learning/memory and neurotransmitters as well as the mechanisms of action on neurotransmitters. This paper aims to provide a scientific basis for future research in this area.
8.Differential expression profiles analysis of DNA methylation between “disease” and “syndrome” in coronary heart disease-induced unstable angina patientswith Qi deficiency and blood stasis syndrome
WU Huaying ; HU Hongchun ; LIU Yufeng ; LI Liang ; LI Jing ; HAN Yuming ; XIAO Changjiang ; PENG Qinghua
Digital Chinese Medicine 2023;6(4):451-466
Objective:
To explore the differential expression profiles of DNA methylation sites/regions and potential molecular mechanisms in the peripheral blood of coronary heart disease (CHD)-induced unstable angina pectoris patients with or without Qi deficiency and blood stasis syndrome, and to provide scientific evidence for the conbination of disease and syndrome.
Methods:
According to the pre-determined inclusion and exclusion criteria, the study subjects were enrolled and divided into two groups namely CHD-induced unstable angina group (G group) and healthy control group (J group) to conduct “disease” analysis, while G group was further divided into Qi deficiency and blood stasis syndrome group (case group) and non-Qi deficiency blood stasis syndrome group (control group) to perform “syndrome” analysis. The general data and clinical information of the study subjects were collected. The peripheral venous blood was extracted on an empty stomach, and the Illumina Infinium MethylationEPIC BeadChip (850K methylation chip) was used to detect the differential expressionprofiles of DNA methylation in each group, ChAMP software (V 2.14.0) was used for the differential methylation data analysis, with a threshold of the adjusted P value (adj.P.val) < 0.01. Gene Ontology (GO) and Kyoto Encyclopedia of Genomes (KEGG) were employed for the functional and pathway enrichment analyses of related mapped genes.
Results:
A total of 263 differentially methylated CpG positions (DMPs) were screened out between G and J groups, including 191 hypermethylated positions such as cg05845204 and cg08906898, and 72 hypomethylated positions such as cg26919182 and cg13149459. These positions were mainly mapped to 148 genes encompassing RNA binding motif protein 39 (RBM39), acetyl-CoA acyltransferase 2 (ACAA2), protein phosphatase 1 regulatory subunit 12B (PPP1R12B), and the dual-specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2). GO functional enrichment analysis revealed that the genes of the DMPs were primarily enriched in protein localization to chromosomes, regulation of cell morphogenesis, negative regulation of calcium-mediated signals, etc. KEGG pathway analysis suggested that the genes were mainly enriched in fatty acid metabolism and endocytosis pathways. In addition, a total of 23 differential methylation regions (DMRs) were identified, with overlapping genes such as transmembrane protein 232 (TMEM232), ribosomal protein large P1 (RPLP1), peroxisomal biogenesis factor 10 (PEX10), and forkhead box N3 (FOXN3) recognized. It was found that GO functions were mainly enriched in the negative regulation of Ras protein signal transduction, small GTPase-mediated signal transduction, negative regulation, etc. A total of 1 703 differential methylation sites were screened out between case and control groups, including 444 increased methylation positions such as cg05573767 and 1 259 decreased methylationpositions such as cg19938535, and cg03893872. These positions were mapped to 1 108 genes such as ribosomal protein S6 kinase A2 (RPS6KA2), leucine rich repeat containing 16A (LRRC16A), and hedgehog acyltransferase (HHAT). According to the GO functional enrichment analysis, the genes relating to the DMPs were mainly enriched in biological functions such as transmembrane receptor protein serine/threonine kinase signaling pathway and axonogenesis. The KEGG pathway enrichment analysis suggested the involvement of Rap1 signaling pathway, adenosine 5’-monophosphate-activated protein kinase (AMPK) signaling pathway, etc. A total of 21 DMRs were identified, including 22 overlapping genes such as mucin 4 (MUC4), three prime repair exonuclease 1 (TREX1), and LIM homeobox 6 (LHX6). GO analysis demonstrated that the genes primarily participated in molecular functions such as positive regulation of transmembrane transport, regulation of fatty acid metabolism, and copper ion binding.
Conclusion
This study reveals the methylation patterns of DMPs and DMRs in patients with Qi deficiency and blood stasis syndrome caused by CHD-induced unstable angina pectoris. Potential epigenetic regulation of fatty acid metabolism, Rap1 signaling, and other molecular functions are involved in the development of CHD between the "disease" and "syndrome".
9.Expression and regulation of keratin 6B in CD44+ bladder cancer stem cells
Lu LIU ; Yuming YANG ; Aichen SHANG ; Cui LIU ; Ce SUN ; Jing WANG
Chinese Journal of Tissue Engineering Research 2022;26(1):76-83
BACKGROUND: Bladder cancer stem cells could promote the recurrence and drug resistance of bladder cancer. Numerous studies have shown that keratin 6B (KRT6B) is involved in the production and progression of tumors, and is closely related to the prognosis of tumors. OBJECTIVE: To observe the expression of keratin 6B in CD44+ bladder cancer stem cells and to show the influence of keratin 6B on proliferation, migration, and self-renewal of bladder cancer stem cells, and to further explore the effect of keratin 6B expression on the prognosis of bladder cancer patients. METHODS: (1) CD44+ 5637 bladder cancer stem cells were isolated by magnetic active cell sorting. Cancer stem cell-related gene expression of SOX2, OCT4, and NANOG was detected via real-time polymerase chain reaction. The spheroid formation assay was used to detect the ability of self-renewal of cancer stem cells in CD44+ cells. Keratin 6B expression was detected in CD44+ bladder cancer stem cells by real-time polymerase chain reaction. (2) The CD44+5637 bladder cancer stem cells were divided into two groups. In the keratin 6B siRNA group, keratin 6B small interfering RNA was transfected into CD44+ bladder cancer stem cells. Untransfected CD44+ bladder cancer stem cells were used as the black control group. Cells were collected at 2 days post-transfection. The proliferation, migration, and self-renewal capacity of keratin 6B siRNA CD44+ bladder cancer stem cells were detected by the colony and wound healing assay and spheroid formation respectively. (3) Totally 24 bladder cancer tissues were used by immunohistochemistry to analyze the expression of CD44v6 and keratin 6B. (4) ONCOMINE database was used to analyze the effect of keratin 6B expression on the overall survival of bladder cancer. RESULTS AND CONCLUSION: (1) Cancer stem cell-related genes (SOX2, OCT4, NANOG) and keratin 6B expression was higher in CD44+ cells isolated by magnetic active cell sorting compared with CD44- cells (P < 0.05). Cell proliferation, migration, and in vitro spheroid formation were significantly increased (P < 0.05). Keratin 6B small interfering RNA down-regulated the expression of keratin 6B in CD44+ bladder cancer stem cells (P < 0.05). (2) Compared with the blank control group, the proliferation and migration of CD44+ bladder cancer stem cells after transfection of keratin 6B small interfering RNA (P < 0.05), and the number of tumorsphere significantly diminished (P < 0.05); the expression of Notch1 and Hes1 mRNA increased (P < 0.05). (3) Keratin 6B and CD44v6 were significantly different in bladder cancer tissue (P=0.006). The overall survival rate of bladder cancer patients with high expression of keratin 6B was lower than that of patients with low expression of keratin 6B. (4) The results showed that keratin 6B was highly expressed in CD44+ bladder cancer stem cells, and could promote the proliferation, migration, and self-renewal capacity of bladder cancer stem cells. The high expression of keratin 6B contributes to improving the survival of bladder cancer patients.
10.Efficacy of 68Ga-PSMA PET/CT in evaluating lymph node metastasis of prostate cancer
Yuming JING ; Jianhua JIAO ; Jingliang ZHANG ; Jian CHEN ; Wenhui YANG ; Yang ZHANG ; Xiaojian YANG ; Fei KANG ; Jing WANG ; Weijun QIN
Chinese Journal of Urology 2022;43(7):500-504
Objective:To study the efficacy of 68Ga-PSMA PET/CT in evaluating lymph node metastases (LNMs) in patients with prostate cancer (PCa). Methods:Patients who recieved 68Ga-PSMA PET /CT examination in the First Affiliated Hospital of Air Force Military Medical University from July 2021 to February 2022 were enrolled. The patients’ age was (64.4±6.1) years old, with median total prostate specific antigen (tPSA) 34.5 (6.1-99.0) ng/ ml, including PSA<10ng/ ml in 12 cases, 10-20ng/ ml in 21 cases, and > 20 ng/ml in 25 cases. Preoperative clinical staging: 1 case in T 1 stage, 38 cases in T 2 stage, 16 cases in T 3stage, 3 cases in T 4 stage. Preoperative Gleason score of 10 cases was <7, 20 cases was 7, and 28 cases was > 7. According to D 'Amico risk grouping criteria, there were 8 cases in the low-risk group, 20 cases in the medium-risk group and 30 cases in the high-risk group. Preoperative examination of 68Ga-PSMA PET/CT showed no distant metastasis such as visceral metastasis and bone metastasis. All patients underwent radical prostatectomy and pelvic lymph node dissection. The following patients were excluded: patients received preoperative prostate surgery, patients received endocrine therapy, chemotherapy and radiotherapy for prostate cancer before surgery, a history of other malignant tumors in the past 2 years, biopsy pathological diagnosis of neuroendocrine cell prostate cancer and other special types of prostate cancer, prior history of major pelvic surgery, etc. Radical prostatectomy was performed. 38 patients received laparoscopic surgery and 20 patients received robot-assisted laparoscopic surgery. The sensitivity and specificity of 68Ga-PSMA PET /CT for the diagnosis of lymph node metastasis of prostate cancer were calculated according to the comparison of lymph node metastasis in postoperative pathological results and preoperative examination. Results:Postoperative pathological diagnosis: Gleason score of 9 cases was <7, 19 cases was 7, and 30 cases was >7. 37 cases were in pT 2 stage, 17 cases in pT 3 stage, and 4 cases in T 4 stage. There were 12 cases (20.7%) of positive resection margin, and 7 cases (12.1%) of lymphatic fistula. There were 10 patients with lymph node metastasis diagnosed by 68Ga-PSMA PET/CT before surgery, and 17 positive lymph node regions. A total of 11 patients were pathologically positive in lymph nodes, and a total of 20 lymph nodes regions were positive. Based on the number of patients, the specificity and sensitivity of 68Ga-PSMA PET /CT in diagnosing lymph node metastasis in patients were 97.9% (46/47) and 81.2% (9/11), respectively. Based on the number of regional lymph nodes, the specificity and sensitivity of 68Ga-PSMA PET /CT for regional lymph node diagnosis were 99.4%(326/328) and 75.0%(15/20), respectively. The specificity of lymph node metastasis in the external iliac group, the internal iliac group and the obturator group were 100.0%(114/114), 99.1%(110/111) and 98.1%(101/103), and the sensitivity was 100.0%(2/2), 60.00%(3/5) and 69.2%(9/13), respectively. Conclusion:68Ga-PSMA PET/CT can be used as a strong tool for precise guidance of PLND in PCa patients.


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