Objective To investigate the assessing value of C-reactive protein to serum albumin ratio(CRP/Alb)and pan-im-mune-inflammation value(PIV)in the prognosis of advanced non-small cell lung cancer(NSCLC)before receiving first-line PD-1/PD-L1 inhibitors combined with chemotherapy.Methods The clinical data of 85 patients diagnosed with advanced NSCLC in the Affili-ated Hospital of Xuzhou Medical University from November 2018 to December 2021 who received first-line treatment with PD-1/PD-L1 inhibitors combined with chemotherapy regimens were retrospectively analyzed.The receiver operator characteristic curve(ROC curve)was used to determine the optimal cut-off value of CRP/Alb and PIV,and univariate and multivariate analysis were performed on the COX proportional risk regression model.Results In this study,a total of 85 patients were included,and the optimal cut-off value of CRP/Alb was 0.38,and the difference between the advanced NSCLC patients in the high and low CRP/Alb groups in the history of smok-ing and hypertension was statistically significant(P＜0.05);the optimal cut-off value of PIV was 666.77,and the difference in ECOG-PS scores between the advanced NSCLC patients in the high and low PIV groups was statistically significant(P＜0.05).The dis-ease control rate(DCR)and progression-free survival(PFS)of patients in the high CRP/Alb group and the high PIV group were lower than those in low CRP/Alb and low PIV groups,and the difference was statistically significant(P＜0.05).Univariate and multivariate COX regression analysis showed that high CRP/Alb and high PIV were predictors of poor prognosis of PFS in patients with advanced NSCLC in the first-line treatment of PD-1/PD-L1 inhibitors and chemotherapy regimens.Conclusion High CRP/Alb and high PIV are associated with poorer PFS in patients with advanced NSCLC,and may be potentially valuable prognostic factors for patients with ad-vanced NSCLC treated with first-line immunotherapy combined with chemotherapy.

Objective: To observe the differential expression of miRNAs between human dental pulp stem cells(DPSCs) and stem cells from the apical papilla(SCAPs). Methods: DPSCs and SCAPs were isolated by immune-magnetic binding specific STRO-1 antibody separation system. Osteogenic and adipogenic differentiation of DPSCs and SCAPs were tested by ALP assay, alizarin red staining(ARS) and Oil Red O staining. Differential miRNA expression of DPSCs and SCAPs was screened by the Next generation sequencing. Target genes and their possible roles of these differential miRNAs were predicted using biological information analysis. Results: The results revealed that 7 miRNAs(hsa-miR-224-5p, hsa-miR-1247-5p, hsa-miR-3065-3p, hsa-miR-452-5p, hsamiR-767-5p, hsa-miR-4284, hsa-miR-146a-5p) were downregulated while no miRNAs was upregulated in SCAPs compared with DPSCs. 27 target genes which mainly involved in the cell migration, differentiation and apoptosis were found. Conclusion: Downregulation of some specific miRNAs might be related to the stemness of SCAPs.

BACKGROUND AND PURPOSE: Large cohort studies on relationship between family history of stroke (FHS) and stroke risk are lacking in Asians. We aimed to systematically evaluate the association of FHS with stroke risk in a cohort study of 0.5 million Chinese adults. METHODS: Information about FHS was self-reported. The median follow-up time was 7.16 years and the end-point of follow-up was incident stroke, which was entered directly into the China Kadoorie Biobank system. Multivariate analyses were performed with Cox proportional hazards model, and interaction analyses were carried using likelihood-ratio tests. RESULTS: Compared with participants without FHS, the hazard ratio (HR) (95% confidence interval, CI) of stroke for participants with FHS was 1.50 (1.46-1.55). The HRs increased with the number of first degree relatives with stroke (HRs=1.41, 1.98 and 2.47 for 1, 2 and ≥3 relatives, respectively, P(trend) <0.001). The HRs were 1.57 (95% CI: 1.50-1.66) and 1.49 (95% CI: 1.45-1.54) for sibling history and parental history, respectively. Similar associations with offspring stroke risk were observed between paternal history (HR=1.48, 95% CI: 1.43-1.54) and maternal history (HR=1.49, 95% CI: 1.43-1.55). Moreover, significant interactions were detected between FHS and health-risk behaviors (tobacco smoking and alcohol drinking). CONCLUSIONS: FHS is an independent risk factor for stroke in Chinese. The more first degree relatives are affected by stroke, the higher are individuals’ risk of suffering from stroke. The management of the health-risk behaviors for reducing stroke should be highlighted, especially for the individuals with FHS.
Adult ; Asian Continental Ancestry Group ; China* ; Cohort Studies* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Parents ; Proportional Hazards Models ; Risk Factors ; Siblings ; Smoke ; Smoking ; Stroke*

Background and objective Non-small cell lung cancer (NSCLC) is one of the most common cause of cancer-related death worldwide.As the overall prognosis for affected patients is still poor,there is a need for biomarkers for prediction of survival and guiding individual therapy.This study is to explore the expression and significance of kinesin family member 23 (KIF23) in NSCLC.Methods KIF23 data were retrieved from Oncomine NSCLC database.The prognostic value of KIF23 was retrieved from an online survival analysis tool "Kaplan-Meier Plotter" (KM plotter) database.Results In Oncomine database,there were 447 studies of different types concerning expression of KIF23,of which 67 studies were of statistically significance (64 up-regulated and 3 down-regulated).A total of 16 studies were involved KIF23 in NSCLC tissues and normal tissues,including a total of 1,189 samples.Overall,KIF23 expression in NSCLC is higher than that in normal tissues (P＜0.05).Moreover,Kaplan-Meier plots of overall survival indicated that KIF23 high expression is closely associated with poor survival in NSCLC (P＜0.05).Subgroup analysis revealed that KIF23 expression showed negative relation to the prognosis of pulmonary adenocarcinoma patients.Whereas,in those with squamous carcinoma KIF23 expression showed no effects on the prognosis of the patients.Conclusion KIF23 was found highly expressed in NSCLC,which might be a marker for NSCLC prognosis.

Teaching urinary system diseases by problem-based learning method for eight-year program medical students was applied in nephrology department in affiliated Tongji hospital of Huazhong university of science and technology since 2008.They had accumulated experiences in compiling teaching plan,fostering teachers,practicing teaching and evaluating teaching.These steps may future intensify education reform on long schooling system and improve teaching quality of eight-year program.

Objective To study the effect of medically activated charcoal on serum phosphorus level and calcium-phosphorus products in dialysis patients with poorly controlled hyperphosphatemia. Methods A single-center,prospective,self-controlled study was performed.Medically activated charcoal was administered 4.5-7.2 g per day with meals for three months to hemodialysis or peritoneal dialysis patients with hyperphosphatemia after taking calcium-based phosphate binders.The levels of blood phosphorus,calcium,calcium-phosphorus products,intact parathyroid hormone (iPTH),albumin and hemoglobin were detected before and after the treatment.The results were analyzed using paired t-test. Results After 3 months of treatment,the patients' serum phosphorus level was significantly reduced from (2.16 ±0.34) mmol/L (pretreatment) to (1.85±0.30) mmol/L (post-treatment) (P＜0.01).Similarly,the serum calciumphosphorus products were lowered from pre-treatment level of (63.93 ±8.83) mg2/dl2 to posttreatment of (54.12±8.37) mg2/dl2 (P＜0.01).Serum albumin level was slightly reduced from (41.7±2.9) g/L to (40.1±2.2) g/L (P=0.001).In contrast,there were no significant changes in serum calcium and iPTH levels when compared pre- to post-treatment values (P=0.734 and P=0.665,repectively). Conclusion In combination with calcium-based phosphate binder therapy,oral medically activated charcoal can effectively reduce the levels of blood phosphorus and calciumphosphorus products in dialysis patients with refractory hyperphosphatemia.

In order to analyze the cai]ses of delayed diagnosis and raise the level of early diagnosis of atypical multiple myeloma (MM), the differences of presenting features between the patients presented to nephrologists and those presented to hematologists were compared. MM patients in our hospital were studied retrospectively. Those who referred renal impairment were divided into two groups: group I presented to nephrologists prior to MM diagnosis (n=29) and group II presented to hematologists directly (n=62). The age, sex, initial symptoms, haematological and biochemical parameters, the phenotype of paraprotein, bone marrow biopsy and cytology were undertaken and analyzed. The results showed that the median time between the initial symptoms and diagnosis in the patients of group I was longer than that in group II (P<0.001); patients in group I had significantly lower incidence of bone pain (P<0.01) and worse renal function (P<0.05) on presentation. There were lower level of myeloma cells (P<0.05), lower incidence of hypergammaglobulinemia (P<0.05), lower positive rate of monoclonal immunoglobulin (M protein) (P<0.05) and M protein level (P<0.05) in the patients of group I than those in group II. The ratio of monoclonal to lambda monoclonal proteins in a population was 1:3.67 in patients of group I, whereas 1:0.90 in patients of group II (P<0.01). Moreover, patients with λ type had a higher degree of renal insufficiency than those with κ type (P<0.05). It was suggested that the median time between the initial symptoms and diagnosis in the patients presented to nephrologists was longer than that in those presented to hematologists; the patients presented to nephrologists had the lower incidence of bone pain, lower level of myeloma cells and M protein, which made early diagnosis more difficult; more patients presented to nephrologists had the majority of λ light chain type, moreover, patients with λ light chain type had a higher incidence of renal insufficiency.

In order to analyze the causes of delayed diagnosis and raise the level of early diagnosis of atypical multiple myeloma (MM),the differences of presenting features between the patients presented to nephrologists and those presented to hematologists were compared.MM patients in our hospital were studied retrospectively.Those who referred renal impairment were divided into two groups:group Ⅰ presented to nephrologists prior to MM diagnosis (n=29) and group Ⅱ presented to hematologists directly (n=62).The age,sex,initial symptoms,haematological and biochemical parameters,the phenotype of pamprotein,bone marrow biopsy and cytology were undertaken and analyzed.The results showed that the median time between the initial symptoms and diagnosis in the patients of group Ⅰ was longer than that in group Ⅱ (P＜0.001); patients in group Ⅰ had significantly lower incidence of bone pain (P＜0.01) and worse renal function (P＜0.05) on presentation.There were lower level of myeloma cells (P＜0.05),lower incidence of hypergammaglobulinemia (P＜0.05),lower positive rate of monoclonal immunoglobulin (M protein) (P＜0.05) and M protein level (P＜0.05) in the patients of group Ⅰ than those in group Ⅱ.The ratio of monoclonal to lambda monoclonal proteins in a population was 1:3.67 in patients of group Ⅰ,whereas 1∶0.90 in patients of group Ⅱ (P＜0.0 l).Moreover,patients with λ type had a higher degree of renal insufficiency than those with κ type (P＜0.05).It was suggested that the median time between the initial symptoms and diagnosis in the patients presented to nephrologists was longer than that in those presented to hematologists; the patients presented to nephrologists had the lower incidence of bone pain,lower level of myeloma cells and M protein,which made early diagnosis more difficult; more patients presented to nephrologists had the majority of λ light chain type,moreover,patients with λ light chain type had a higher incidence of renal insufficiency.

Objective To explore the efficiency of transcervical video-assisted mini-incision thyroidectomy for thyroid tumor. Methods 53 patients with thyroid tumors who underwent the video-assisted mini-incision thyroidectomy from Jan. 2006 to Dec. 2009 in the Department of Thyroid Surgery, Yantai Yuhuangding Hospital,were retrospectively studied. Results All of the patients, except 5 cases converting to open thyroidectomy, underwent the video-assisted mini-incision thyroidectomy successfully. The temporary recurrent laryngeal nerve injury occurred in 1 patients. The subcutaneous fluid accumulation occurred in 3 patients. The skin burns around the incisions occurred in 3 patients. There was no complication of hematoma, hypocalcemia, or superior laryngeal nerve injuries. The follow-up period was from 3 months to 35 months. There was no evidence of recurrence and metastasis by postoperative ultrasonic and CT scan and radioiodine scintigraphy. Conclusions The video-assisted mini-incision thyroidectomy is feasible, safe, and with the advantage of cosmetic results. For thyroid tumor,especially thyroid cancer, longer follow-up is necessary to draw definitive conclusion on recurrence and survival rate.

Objective To explore the clinical manifestations, diagnosis, treatment and prognosis of secondary thyroid neoplasms. Methods To retrospectively analyse clinical manifestations,examinations and treatment of 83 cases of secondary thyroid cancer, which were retrieved from CNKI (1994-2008). Results In all cases, 39 were male, 39 were female and 5 were unknow, aged from 16 to 78 years old, median age was 52. The primary cancers included 31 esophageal carcinomas, 12 lung cancers, 8 laryngopharynx cancers, 7 clear cell renal carcinomas, 6 rectal carcinomas, 6 melanomas, 3 breast cancers, 3 rhabdomyosarcoma, 2 gatric cancers, 1 liver cancer, 1 cervical cancer, 1 nonchromaffin paraganglioma,1 ovary cancer, 1 lip squamous cell carcinomac. 64 patients had undergone chemotherapy or surgery or radiotherapy. The intervals between finding of primary carcinoma and secondary thyroid carcinoma ranged from 1 month to 26 years with a median time of 2.5 years. Patients died of widespread metastases from 1 month to 12 years following the diagnosis of secondary carcinoma in thyroid, with a median time of 32 months. Conclusions Metastasis in the thyroid gland is uncommon and may cause a diagnostic problem. Metastatic cancer to the thyroid should be considered when a patient with histoy of malignant tumor has a recent found thyroid lesions. With the combination of Surgery, chemotherapy and radiotherapy, the survival of patients can be significantly prolonged.