Objective:To construct a prognostic risk prediction model for colorectal cancer(CRC)based on endoplasmic reticulum stress(ERS)-related genes,and to evaluate the value of the model in predicting the prognosis of CRC.Methods:The gene data and clinical information of CRC group were downloaded from the TCGA database,and a prognostic risk prediction model based on ERS-related genes was designed by LASSO regression and multivariate Cox regression analysis.The model was used to predict the prognostic risk and immune response of CRC pa-tients,and the ROC curve was used to evaluate the efficacy of the risk prediction model.Re-sults:A total of 255 ERS-related genes were found in the data of 455 CRC cases,and 11 prognosis-related genes,including HSPA1A,MAGEA3,ATP2A1,DNAJB2,DNAJC3,EIF2B5,FLOT1,GET4,HERPUD2,STC2 and TMUB1,were screened by multivariate Cox regression,and a prognostic risk prediction model was constructed,with risk score=0.151 × HSPA1A+0.240 × MAGEA3+1.715 × ATP2A1+1.162 × DNAJB2-0.563 × DNAJC3+1.127 × EIF2B5+0.653 × FLOT1-1.580 × GET4+1.684 × HERPUD2+0.260 × STC2+0.710 × TMUB1.Higher risk scores were associ-ated with worse prognosis,immune response,drug sensitivity in patients and the lower the TMB score.Compared to traditional TNM staging,the area under the ROC curve(AUC=0.78)and C in-dex of the prognostic risk prediction model were higher.Conclusion:The prognostic risk predic-tion model of ERS-related genes has a good predictive effect on the prognosis of CRCand pro-vides guidance for the application of immunotherapy.

OBJECTIVE: To explore the diagnostic value of ¹⁸F-FDG PET/CT in bone marrow infiltration (BMI) of newly diagnosed diffuse large B-cell lymphoma (DLBCL), compared with the results of bone marrow biopsy (BMB) and investigate whether the BMI diagnosed by ¹⁸F-FDG PET/CT and other factors have independent prognostic values. METHODS: Ninety-four newly diagnosed DLBCL patients who underwent PET/CT in Clinical Medical College of Shanghai General Hospital of Nanjing Medical University were included. BMB was performed within 2 weeks before or after PET/CT, and standardized treatment was performed after PET/CT. The manifestations of bone marrow (BM) FDG uptake were recorded. The diagnostic criteria of BMI were BMB positive or focal BM FDG uptake confirmed by imaging follow-up. The relationship between clinical features and BM FDG uptake and the values of PET/CT and BMB in the diagnosis of BMI was analyzed. The progression-free survival (PFS) was analyzed by Kaplan-Meier survival curves, log-rank test was used to compare PFS rate, and Cox regression model was used to analyze the independent risk factors affecting PFS. RESULTS: Among 94 DLBCL patients, 34 patients showed focal BM uptake (fPET), 7 patients showed super BM uptake (sBMU), 11 patients showed diffuse homogenous uptake higher than liver (dPET), and the other 42 patients had normal BM uptake (nPET) (lower than liver). BMB positive was found in all sBMU patients, in 20.6%(7/34) of fPET patients, and in 27.3% (3/11) of dPET patients. All nPET patients had negative BMB results. dPET patients were associated with lower hemoglobin level and leukocyte count compared with nPET group (P < 0.001, P =0.026). Compared with fPET patients, sBMU patients were more likely to have B symptoms and elevated lactate dehydrogenase (LDH). A total of 44 patients were diagnosed BMI, including 17 cases with BMB⁺. The sensitivity and specificity of BMB in the diagnosis of BMI was 38.6% (17/44) and 100% (50/50), respectively. Using fPET and sBMU as criteria of PET BMI, the diagnostic sensitivity and specificity of PET/CT was 93.2% (41/44) and 100% (50/50), respectively. Kaplan-Meier analysis showed that there was no significant difference in 2-year PFS rate between nPET and dPET patients (P >0.05), while sBMU patients had lower 2-year PFS rate compared with fPET patients (P < 0.001). Multivariate analysis showed that higher Ann Arbor stage (HR=9.010, P =0.04) and sBMU (HR=3.964, P =0.002) were independent risk factors affecting PFS. CONCLUSIONS Increased BM FDG uptake of DLBCL can be manifested as dPET, fPET and sBMU. fPET and sBMU can replace BMB to diagnose BMI. Although dPET cannot completely exclude the possibility of BMI, it does not affect the prognosis, so it can be diagnosed as PET BMI negative. sBMU is an independent prognostic risk factor.
Humans ; Positron Emission Tomography Computed Tomography/methods* ; Fluorodeoxyglucose F18 ; Prognosis ; Bone Marrow/pathology* ; Retrospective Studies ; China ; Positron-Emission Tomography/methods* ; Lymphoma, Large B-Cell, Diffuse/pathology* ; Biopsy

Objective To study the value of three-dimensional high-resolution magnetic resonance wall imaging (3D-HR-VWI)for ischemic stroke caused by perforating artery infarction.Methods Retrospectively studied 38 patients between 201 6 and 2018.3D-HR-VWI technique were used to examine the structures of the ipsilateral and contralateral lenticulostriate arteries of the lesion,to study the characteristics of the perforating artery lesion.Results There was no statistical significance in the absolute number of lenticulostriate arteries on the lesion side and the normal side (P＝0.251 2).There was statistical significance in the ratio of lenticulostriate arteries between two groups (P＝0.020).The differences of the depth of lenticulostriate arteries on lesion sides were also statistical significant between two groups (P＝0.032).The differences among risk factors including hypertension,diabetes,hyperlipidemia and smoking were not statistically significant.There was no statistical significance on the differences of vascular involvement,length of M1 lesions,etiological types, number of lenticulostriate arteries,and depth of lenticulostriate arteries among the lateral lenticulostriate artery group,the internal lenticulostriate artery group and the internal+lateral lenticulostriate artery group.Conclusion 3D-HR-VWI can show the lesions of lenticulostriate arteries and perforating arteries,which is of important in diagnosis of perforating artery infarction.

Objective To analyze the relationship between 18F-FDG PET/CT manifestations,tumor differentiation and PSA for the patients with bone metastases from prostate cancer.Methods Retrospective analysis was executed on the distribution,number and density of bone metastases tumor and FDG uptake as well as the relationship between serum PSA,FDG uptake of bone metastases focus,type of bone metastases and the involved range.Results Of the 25 cases,there were 8 ones of poorly differentiated carcinoma and 17 ones of moderately differentiated carcinoma.All the patients had serum PSA higher than 10 μg/ml,of whom there were 19 ones had the PSA not lower than 20 μg/ml.Eight patients with bone metastases restrained in the pelvis and lower lumbar vertebra,and the remained 17 ones had multiple or diffuse bone metastases.Fisher's exact test showed that non-osteoblastic metastases were more common in low-and medium-differentiation patients (P=0.022),the typing of bone metastases had no relationship with the enhancement of PSA,and there were no statistical differences between the involved ranges of the patients.Conclusion Bone metastases from prostate cancer often occurs in the patient with obviously enhanced PSA and poorly differentiation.18F-FDG PET/CT behaves well in the early diagnosis of bone metastases from prostate cancer.18F-FDG PET/CT manifestations differ with the differentiation of carcinoma,poorly differentiated carcinoma shows non-osteoblastic metastases and high FDG uptake,and moderately differentiated carcinoma appears as osteoblastic metastases and low FDG uptake.There is no confirmed correlation between PET/CT manifestation and total serum PSA for the patients with bone metastases from prostate cancer.

OBJECTIVETo explore the value of (18)F-FDG PET/CT in the diagnosis and treatment evaluation in patients with pretreatment or recurrent extranodular natural killer/T-cell lymphoma nasal type (ENTCL).

METHODS(18)F-FDG PET/CT images and clinical records of 35 cases (67 scans) of pathologically confirmed ENTCL treated in our hospital within the last 9 years were analyzed. The imaging characteristics of the upper aerodigestive tract (UAT) and the non-aerodigestive tract (NUAT) lesions were analyzed. Lesion distribution, clinical stages, SUVmax and patient survival data were compared between pretreatment and recurrent cases.

RESULTSs All the ENTCL lesions were hypermetabolic. The UAT lesions involved mainly the nasal cavity and pharynx, while the NUAT lesions may involve the lymph nodes and all the organs. UAT lesions were more common in pretreatment cases while NUAT lesions tended to increase in recurrent cases. The SUVmax of pretreatment and recurrent lesions were 10.4∓4.4 and 9.6∓5.2, and showed no significant difference among patients with different lesion distribution patterns, clinical stages, or treatment history. The tumor remission rate evaluated by PET/CT were higher in cases with an initial diagnosis than in those with recurrence [(89.5% (17/19) vs 33.3% (5/15), P<0.005)]. Cox regression analysis revealed no significant differences in the survival rates among patients with different treatment history, clinical stages, lesion distribution patterns, or SUVmax levels (P>0.05).

CONCLUSION(18)F-FDG PET/CT can sensitively detect the pretreatment or recurrent lesions in ENTCL patients and helps in accurate tumor staging and curative effect evaluation.

Fluorodeoxyglucose F18 ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnostic imaging ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Positron Emission Tomography Computed Tomography

Oral rinses containing chemotherapeutic agents, such as cetylpyridinium chloride (CPC), can alleviate plaque-induced gingival infections, but how oral microbiota respond to these treatments in human population remains poorly understood. Via a double-blinded, randomised controlled trial of 91 subjects, the impact of CPC-containing oral rinses on supragingival plaque was investigated in experimental gingivitis, where the subjects, after a 21-day period of dental prophylaxis to achieve healthy gingivae, received either CPC rinses or water for 21 days. Within-subject temporal dynamics of plaque microbiota and symptoms of gingivitis were profiled via 16S ribosomal DNA gene pyrosequencing and assessment with the Mazza gingival index. Cetylpyridinium chloride conferred gingival benefits, as progression of gingival inflammation resulting from a lack of dental hygiene was significantly slower in the mouth rinse group than in the water group due to inhibition of 17 gingivitis-enriched bacterial genera. Tracking of plaqueα andβ diversity revealed that CPC treatment prevents acquisition of new taxa that would otherwise accumulate but maintains the original biodiversity of healthy plaques. Furthermore, CPC rinses reduced the size, local connectivity and microbiota-wide connectivity of the bacterial correlation network, particularly for nodes representing gingivitis-enriched taxa. The findings of this study provide mechanistic insights into the impact of oral rinses on the progression and maturation of dental plaque in the natural human population.

OBJECTIVETo analyze the risk factors for hospital mortality after operations for type A aortic dissection.

METHODSTotally 766 consecutive patients (586 male and 180 female patient, aged (45±12) years, ranging from 16 to 78 years), who underwent surgery for type A aortic dissection from January 2001 to December 2010, were studied retrospectively. Preoperative and operation related clinic factors were analyzed by univariate analysis, followed by Logistic regression model, to identify the risk factors of hospital mortality.

RESULTSOverall, 37 patients (4.8%) died during hospitalization. On univariate analysis, significant risk factors for hospital mortality were male, acute status, renal dysfunction, cardiac dysfunction, cardiopulmonary bypass time, duration of operation, volume of blood transfusion, re-operation for bleeding (χ2=4.008-27.093, P<0.05). On Logistic regression model, independent risk factors were acute status (OR=2.784, 95%CI: 1.166-6.649, P=0.021), renal dysfunction (OR=6.285, 95%CI: 1.738 - 22.723, P=0.005), cardiac dysfunction (OR=3.052, 95%CI: 1.083-8.606, P=0.035), re-operation for bleeding (OR=3.690, 95%CI: 1.262-10.791, P=0.017), volume of blood transfusion (OR=1.033, 95%CI: 1.008-1.058, P=0.010). Additionally, male (OR=0.387, 95%CI: 0.177-0.848, P=0.018) was protective factor, and alternatively, female was indeed one of the independent risk factors for hospital mortality.

CONCLUSIONFemale, acute status, renal dysfunction, cardiac dysfunction, re-operation for bleeding, volume of blood transfusion were independent risk factors for hospital mortality after operations for type A aortic dissection.

Adolescent ; Adult ; Aged ; Aneurysm, Dissecting ; mortality ; surgery ; Aortic Aneurysm, Thoracic ; mortality ; surgery ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Young Adult

BACKGROUNDBacterial lipopolysaccharide (LPS) can activate immunological cells to secrete various proinflammatory cytokines involved in the pathophysiological process of disseminated intravascular coagulation (DIC) during infection. In recent years, it has been found that bone marrow-derived mesenchymal stem cells (BMSCs) can affect the activity of these immune cells and regulate the secretion of proinflammatory cytokines. Here, we report the possible protective effect of BMSCs pre-treatment in LPS-induced DIC rat model and the mechanism.

METHODSForty-eight adult male rats were divided into five experimental groups and one control group with eight animals in each group. In the treatment groups, 0, 1'10(6), 2'10(6), 3'10(6), and 5'10(6) of BMSCs were injected intravenously for 3 days before LPS injection, while the control group was treated with pure cell culture medium injection. Then, the LPS (3 mg/kg) was injected via the tail vein in the treatment groups, while the control group received 0.9% NaCl. Blood was withdrawn before and 4 and 8 hours after LPS administration. The following parameters were monitored: platelets (PLT), fibrinogen (Fib), D-dimer (D-D), activated partial thromboplastin time (APTT), prothrombin time (PT), tumor necrosis factor-a (TNF-a), interferon-g (IFN-g), interleukin-1b (IL-1b), creatinine (Cr), alanine aminotransferase (ALT), creatinine kinase-MB (CK-MB), and endothelin (ET).

RESULTSCompared with the control group, a significant change of coagulation parameters were found in the experimental groups. The plasma level of the inflammatory mediator (TNF-a, IFN-g, IL-1b), organ indicator (Cr, ALT, and CK-MB), and ET in the experimental groups were much lower (P < 0.05) than that in the control group. Furthermore, some of these effects were dose-dependent; the statistical comparison of the plasma levels between the groups (from group 2 to group 5) showed a significant difference (P < 0.05), except the ALT and CK-MB levels (P > 0.05).

CONCLUSIONPre-treatment with BMSCs can attenuate organ dysfunction and inhibit systemic intravascular coagulation effectively via the regulatory effect on immune cells and proinflammatory cytokines in LPS-induced DIC rat model.

Alanine Transaminase ; metabolism ; Animals ; Blood Coagulation ; drug effects ; Bone Marrow Cells ; cytology ; Creatinine ; metabolism ; Interferon-gamma ; metabolism ; Interleukin-1beta ; metabolism ; Lipopolysaccharides ; pharmacology ; Male ; Mesenchymal Stromal Cells ; cytology ; physiology ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; metabolism

This study was aimed to explore the significance of the bone marrow biopsy for the diagnosis of multiple myeloma. Bone marrow smears and bone marrow biopsy originated from 279 cases of multiple myeloma were detected and compared in term of bone marrow hyperplasia, bone marrow plasma cell infiltration, proliferation mode, pathological changes in the bone marrow stroma and myelofibrosis. The results indicated that the levels of proliferation in bone marrow biopsy was significantly higher than that in bone marrow smears. Plasma cell proliferation mode in bone marrow biopsy was not completely consistent with the proportion of plasma cells in bone marrow smears. The myelofibrosis level displayed influence on the consistency of the proliferation between bone marrow smears and biopsies. It is concluded that as compared with bone marrow smears the bone marrow biopsy can more accurately reflect the levels of bone marrow hyperplasia and bone marrow plasma cell infiltration, proliferation mode and so on. Bone marrow biopsy is valuable for multiple myeloma diagnosis.
Adult ; Aged ; Aged, 80 and over ; Biopsy ; methods ; Bone Marrow ; pathology ; Bone Marrow Examination ; methods ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; pathology

Background Bacterial lipopolysaccharide (LPS) can activate immunological cells to secrete various proinflammatory cytokines involved in the pathophysiological process of disseminated intravascular coagulation (DIC) during infection.In recent years,it has been found that bone marrow-derived mesenchymal stem cells (BMSCs) can affect the activity of these immune cells and regulate the secretion of proinflammatory cytokines.Here,we report the possible protective effect of BMSCs pre-treatment in LPS-induced DIC rat model and the mechanism.Methods Forty-eight adult male rats were divided into five experimental groups and one control group with eight animals in each group.In the treatment groups,0,1×106,2×106,3×106,and 5×106 of BMSCs were injected intravenously for 3 days before LPS injection,while the control group was treated with pure cell culture medium injection.Then,the LPS (3 mg/kg) was injected via the tail vein in the treatment groups,while the control group received 0.9％ NaCl.Blood was withdrawn before and 4 and 8 hours after LPS administration.The following parameters were monitored:platelets (PLT),fibrinogen (Fib),D-dimer (D-D),activated partial thromboplastin time (APTT),prothrombin time (PT),tumor necrosis factor-o (TNF-α),interferon-γ (IFN-γ),interleukin-1β (IL-1β),creatinine (Cr),alanine aminotransferase (ALT),creatinine kinase-MB (CK-MB),and endothelin (ET).Results Compared with the control group,a significant change of coagulation parameters were found in the experimental groups.The plasma level of the inflammatory mediator (TNF-α,IFN-γ,IL-1β),organ indicator (Cr,ALT,and CK-MB),and ET in the experimental groups were much lower (P ＜0.05) than that in the control group.Furthermore,some of these effects were dose-dependent; the statistical comparison of the plasma levels between the groups (from group 2 to group 5) showed a significant difference (P＜0.05),except the ALT and CK-MB levels (P＞0.05).Conclusion Pre-treatment with BMSCs can attenuate organ dysfunction and inhibit systemic intravascular coagulation effectively via the regulatory effect on immune ceils and proinflammatory cytokines in LPS-induced DIG rat model.