الملخص
Objective To investigate the signal abnormality of conus medullaris in patients with overactive bladder(OAB)and un-deractive bladder(UAB)by MRI diffusion tensor imaging(DTI). Methods From May,2021 to April,2023,23 patients with lower urinary tract dysfunction without trauma and supraspi-nal lesions were enrolled(case group).All patients underwent imaging urodynamics and pelvic floor electromy-ography.Based on the bladder contraction during the filling phase of urodynamics,the patients were divided into UAB group and OAB group.Eight healthy subjects were included as the control group.All participants under-went T10 to L5 spinal segment MRI scans and DTI scans.The position of conus medullaris was determined by comparing the DTI sequences with the MRI scans.The fractional anisotropy(FA),apparent diffusion coefficient(ADC),and relative anisotropy(RA)of the conus medullaris intermediate segment were compared. Results Twelve cases were in UAB group,and eleven in OAB goup.Abnormalities were found in the pelvic floor elec-tromyography in the case group.There was significant difference in sacral reflex arc nerve conduction testing be-tween UAB and OAB groups(P = 0.036).Compared with the control group,ADC increased(t = 2.185,P = 0.037)in the case group;FA decreased(t = 3.439,P = 0.005)and ADC increased(t = 4.582,P<0.001)in UAB group. Conclusion DTI is helpful to find the potential lesion of spinal cord in patients with lower urinary tract dysfunction.FA and ADC are valuable indicators for the diagnosis of conus medullaris injury.
الملخص
Objective:To assess the value of platelet-to-albumin ratio on overall survival(OS) and cancer specific survival(CSS) in patients with upper urinary tract urothelial carcinoma(UTUC).Methods:169 patients with UTUC in Qilu hospital of Shandong University from January 2006 to December 2013 were included in this study, retrospectively. 107(63.3%) were male and 62(36.7%) were female. Their age ranged from 36 to 87 years old, mean 65 years old. 73(43.2%)were less than 65 years old and 96(56.8%) were more than 65 years old. 38 patients had the history of smoking.15 patients had the history of bladder cancer. The single tumor was found in 159 cases (94.1%). 10 patients(5.9) owned more than one site of tumor. For the ECOG, 159 cases (94.1%) were 0 score and 10 cases(5.9%) were ≥1 score. The mean Platelet count was 217.0×10 9/L, ranging (68.0-772.0)×10 9/L. The average serum albumin was 42.0 g/L, ranging (27.3-52.7)g/L. The mean PAR was 5.40×10 9, ranging(0-17.31)×10 9. 147(87.0%) patients accepted radical nephroureterectomy and 22(13.0%) cases accepted segmental ureterectomy.155 cases(91.7%) used postoperative adjuvant chemoradiation. The patients were divided into two groups as low PAR or high according to the receiver operating curve (ROC)analysis of PAR. And the Kaplan-Meier analysis was used to assess the OS and CSS and test the equivalences of the curves by log-rank tests. Univariate and multivariate survival analyses were carried out using Cox proportional hazards regression model. Results:We set 6.67×10 9 was the optimal cutoff value of PAR. Therefore, the cohort was divided into 2 groups, 133(78.7%) patients had low PAR (<6.67×10 9) and 36 patients had high PAR (≥6.67×10 9). The 3-year OS and 5-year OS of high preoperative PAR group were 50.0% and 46.2%, respectively. And low preoperative PAR group were 77.6% and 66.7%, respectively. In univariate analysis, no difference was found in gender, age, tumor size, history of smoking and LVI. Meanwhile, tumor grade (G 1-2 or G 3), pathological T stage (pT a/T 1 or pT 2-4) and PAR (<6.67×10 9 or ≥6.67×10 9) were significantly associated with OS and CSS. Multivariate analysis with a Cox proportional hazards regression model were performed and showed that PAR was significantly associated with OS and CSS (OS: HR=1.850, 95% CI 1.095-3.127, P=0.022; CSS: HR=2.154, 95% CI 1. 242-3.736, P=0.006). Conclusions:Preoperative PAR is an independent prognostic factor in predicting patient with UTUC. And the platelet and serum albumin level are low cost and easy to obtain. PAR may be expected to become a biological factor to predict the prognostic factor in patients with UTUC.
الملخص
The liver has been characterized as a frontline lymphoid organ with complex immunological features such as liver immunity and liver tolerance. Liver tolerance plays an important role in liver diseases including acute inflammation, chronic infection, autoimmune disease, and tumors. The liver contains a large proportion of natural killer (NK) cells, which exhibit heterogeneity in phenotypic and functional characteristics. NK cell activation, well known for its role in the immune surveillance against tumor and pathogen-infected cells, depends on the balance between numerous activating and inhibitory signals. In addition to the innate direct "killer" functions, NK cell activity contributes to regulate innate and adaptive immunity (helper or regulator). Under the setting of liver diseases, NK cells are of great importance for stimulating or inhibiting immune responses, leading to either immune activation or immune tolerance. Here, we focus on the relationship between NK cell biology, such as their phenotypic features and functional diversity, and liver diseases.