الملخص
Head and neck malignant tumor is one of the most heterogeneous diseases.The multi-disciplinary team(MDT)is an essen-tial component for personal precise diagnosis,treatment and integrated care management of oncologic diseases including head and neck malignant tumor.MDT clinical practice is also an important teaching mode for head and neck malignant tumors,but it is limited by time and space in actual teaching.An internet visualization platform was constructed based on the Internet,hospital HIS/PACS/LIS/EMR system,medical visualization screen,oral endoscope,remote consultation platform and other accessible audio and video terminals,and has been applied in MDT clinical teaching of head and neck malignant tumors,allowing medical students to participate in MDT through a networked visualization platform.Medical students will achieve deep learning for the most heterogeneous malignant tumor.MDT sup-ported by the internet visualization platform provides a new pathway for clinical medical education.
الملخص
Objective To investigate the effect of C1q/tumor necrosis factor-related protein 13 protein(CTRP13)on the autophagy function of primary rat liver sinusoidal endothelial cells(rLSECs)induced by high glucose through AMP-activated protein kinase/mammalian target of rapamycin complex(AMPK/mTOR)pathway.Methods After isolation,identification and culture,original rat liver sinusoid endothelial cells(rrLSECs)were divided into normal control(NC)group,high glucose(HG)group,HG +LV-CTRP13 group,HG+ lentiviral empty vector(LV-Con)group(HG+LV-Con).CTRP13 lentivirus over expression vector(LV-CTRP13)and lentivirus empty vector(LV-Con)were constructed and transfected into rrLSECs.According to the intervention methods of AMPK inhibitor Compound C,mTOR inhibitor Torin1 and autophagy inhibitor 3MA,the transfected cell were divided into normal control(NC)group,high glucose(HG)group,HG+LV-CTRP13 group,HG+lentiviral empty vector(LV-Con)group(HG+ LV-Con).qRT-PCR and western blot were used to detect the mRNA and protein expression levels of CTRP13,autophagy related protein Beclin1,human microtubule-associated protein light chain 3II(LC3II),human plasma membrane membrane vesicle association proteins(PLVAP)and p-AMPK and p-MTOR in rat rLSECs of each group.Results Compared with NC group,the number of autophagosome was decreased in HG and HG+LV-CTRP13 group(P<0.05).Compared with HG group,the number of autophagosome bodies was increased in HG +LV-CTRP13 group(P<0.05).The CTRP13 mRNA and protein expression was higher in NC and HG + LV-CTRP13 groups than in HG and HG + LV-Con groups(P<0.05).In HG+LC-CTRP13 group,Beclin1,LC3II,p-AMPK,and AMPK mRNA,Beclin1,LC3II/LC3I protein expression were higher than HG and HG + LV-Con group(P<0.05),PLVAP,p-mTOR,mTOR mRNA,and PLVAP protein expression were lower than HG and HG+LV-Con group(P<0.05).Comparison with HG + LV-CTRP13,p-mTOR protein expression in HG+LV-CTRP13+Compound C group increased(P<0.05),while expressions of CTRP13,Beclin1 and LC3II/LC3I protein decreased(P<0.05);the protein expressions of p-AMPK,Beclin1 and LC3II/LC3I were increased in HG+LV+ CTRP13+Torin1 group(P<0.05),while CTRP13 and p-mTOR protein expression was decreased(P<0.05);protein expressions of p-AMPK,p-mTOR and LC3II/LC3I were higher in HG+LV-CTRP13 + 3MA group(P<0.05),while LC3II/LC3I protein expression was lower(P<0.05).Conclusion CTRP13 overexpression activates AMPK/mTOR-autophagy signaling pathway,which may play a protective role in the function of rLSECs anddelay liver sinusoid capillarization.
الملخص
Objective To investigate the significance of cerebrospinal fluid albumin (CAlb) and cerebrospi-nal fluid immunoglobulin G (CIgG ) in the diagnosis of nervous system inflammatory diseases .Methods A retrospective analysis of 104 patients with cerebrospinal fluid examination from April 2016 to March 2017 in the hospital who were divided into 59 cases of inflammatory disease and 45 cases of non-inflammatory .Blood clearance protein (SAlb) ,CAlb and G IgG were examined(QAlb=CAlb/SAlb) and compared .Results After logarithmic transformation ,ln(CIgG) 4 .36 ± 1 .00 ,ln(CAlb) 6 .31 ± 0 .77 ,ln(QAlb) 2 .57 ± 0 .79 in inflamma-tory group ,compared with non-inflammatory group ,ln(CIgG) 3 .53 ± 0 .59 ,ln(CAlb) 5 .52 ± 0 .50 ,ln(QAlb) 1 .88 ± 0 .47 ,the difference ,were statistically significant (P< 0 .05) .Conclusion The degree of blood-brain barrier damage is different in different nervous system diseases ,and the synthesis of IgG is different ,CIgG , CAlb ,QAlb can be used as an indicator to judge the blood-brain barrier damage ,and can also be used in the differential diagnosis of inflammatory and non-inflammatory diseases of the nervous system .The increase of CIgG also suggests that the occurrence of the disease may be related to autoimmunity .
الملخص
Objective To investigate the different diagnostic value of serum Chitinase 3-like 1 protein(CHI3L1)and Alpha-fe-toprotein(AFP)in diagnosing hepatocellular carcinoma (HCC).Methods One hundreds HCC patients confirmed by histopa-thology were recruited between December,2015 to April,2016 from the First Affiliated Hospital of Nanjing Medical Univer-sity.Simultaneously,100 patients with chronic hepatitis B and 59 healthy individuals,matched by sex and age with HCC pa-tients,were recruited as control groups.Serum CHI3L1and AFP were measured in different groups and the difference were analyzed by STATA 1 2.0 Statistical software.The ability of these two items in differentiating different group was analyzing by ROC curve using MedCal Ver 15.2.2 software.Results Serum CHI3L1 were significantly differences in the three groups using Kruskal-Wallis analysis (χ2=93.19,P=0.000),the differences were further compared in different two groups using Mann-Whitney analysis.The results showed that serum CHI3L1 in HCC group were significantly higher than in chronic hepatitis B and healthy control group (P=0.000,z=8.766,7.400).Serum AFP were significantly differences in the three groups using Kruskal-Wallis analysis (χ2=147.54,P=0.000),and the differences were further compared in different two groups using Mann-Whitney analysis.The results showed that serum AFP in HCC group were significantly higher than in chronic hepatitis B and healthy control group (P=0.000,z=10.938,9.033).The ROC curve analysis of serum CHI3L1 and AFP for differentiating HCC group from CHB group showed that CHI3L1 yield AUC of 0.859 (95% CI:0.803~0.904) with 85% sensitivity,79% specificity and 76.8 pg/ml cut-off value,AFP yield AUC of 0.948 (95% CI:0.904~0.974)with 85% sensitivity,98% specificity and 7.6 ng/ml cut-off value,in distinguishing HCC with CHB group,the power of AFP was superior to that of CHI3L1 (P=0.006).The ROC curve analysis of serum CHI3L1 and AFP for differentiating HCC group from healthy individuals group showed that CHI3L1 yield AUC of 0.852 (95% CI:0.787~0.903)with 85% sensi-tivity,76% specificity and 76.8 pg/ml cut-off value,AFP yield AUC of 0.929 (95% CI:0.878~0.964)with 84% sensitivi-ty,100% specificity and 7.8 ng/ml cut-off value,in distinguishing HCC with healthy individuals group,the power of AFP was also superior to that of CHI3L1 (P=0.045).Conclusion Serum CHI3L1 similar to AFP has much power ability to di-agnosis HCC,but AFP was superior to CHI3L1.
الملخص
Objective To establish the reference interval for serum prostate-specific antigen (PSA) in apparent healthy men of different ages in Nanjing.Methods A total of 25 820 healthy men undergoing routine physical examinations in the First Affiliated Hospital of Nanjing Medical University from October 2013 to September 2015 were selected for the study.All of them were screened by prostate B ultrasound,excluding abnormal urinary tract diseases.The concentration of serum PSA and free prostate-specific antigen (fPSA) were measured by automatic luminescence immunoassay analyzer,and the fPSA/PSA values were calculated.The participants were divided into four groups (20~ 39,40~ 59,60~ 79 and older than 80 years old groups),then the median,5th,25th,75th and 95th percentiles of both PSA and fPSA/PSA were counted,respectively.Results The median of PSA (95th percentile ranges) of these groups by age from low to high were 0.78 (1.93),0.90 (2.93),1.34(6.60) and 2.01(11.91),respectively.The 25th to 75th percentiles were 0.55~1.11,0.61~1.36,0.77~2.51 and 0.94 ~ 4.19,respectively.The median of fPSA/PSA (95 th percentile ranges) were 0.37 (0.60),0.31 (0.56),0.28 (0.53) and 0.29(0.52),respectively.The 25th to 75th percentiles were 0.28~0.46,0.23~0.40,0.22~0.36 and 0.23~ 0.37,respectively.Among all the groups,median differences of both PSA and fPSA/PSA were statistically significant (P<0.05),and PSA levels rise with age.PSA levels in different regions were different.Conclusion The PSA level of men under 40 years in Nanjing should be 0~2.5 ng/ml,40~60 years should be 0~4 ng/ml,while men who are above 60 years,could use 0~5 ng/ml as reference interval.
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Objective To study the correlation between blood uric acid level and blood pressure among general population.Methods 1 694 healthy cases exclusion of hypertension,hyperuricemia and related diseases were enrolled in the study.The levels of blood uric acid,blood pressure,body mass index,fasting glucose,triglycerides,cholesterol were detected and compared.Results In prehypertension group,the levels of uric acid (344.5 ± 41.37)μ mol/L,shrink blood pressure (124.85 ± 7.52) mmHg,diastolic blood pressure (79.46 ± 6.62) mmHg,cholesterol (1.66 ± 1.10) mmol/L,triglycerides (4.69 ± 0.87) mmol/L,fasting plasma glucose (4.98 ± 1.01) mmol/L were significantly higher than those in the normal blood pressure group [(304.09 ± 63.75) μ mol/L,(106.12 ± 8.10) mmHg,(68.53 ± 6.26) mmHg,(1.30 ± 0.87) mmol/L,(4.52 ± 1.02) mmol/L,(4.78 ± 0.70) mmol/L] (t =15.32,49.14,34.81,7.48,3.57,4.67,all P < 0.01).With the increase of uric acid,the levels of shrink blood pressure andthe diastolic blood pressure had an increasing trend(P < 0.01).In prehypertension group,the uric acid level of men was (363.16 ± 32.05) μmol/L,which was significantly higher than female (311.35 ± 34.81) μmol/L (t =22.39,P < 0.05).Conclusion Blood uric acid level and blood pressure level are closely related among general population,the serum uric acid increased in prehypertensive patients.The serum uric acid can provide useful prognostic information in subjects with the hypertension and the cardiovascular disease.
الملخص
Objective To investigate the infection status of hepatitis virus among the perinatal women in Nanjing.Methods 523 samples of perinatal women's serum were selected.The hepatitis virus markers were detected by the ELISA kit,the quantitive detection of HBV surface-antibody was detected by electrochemiluminescence immunoassay.Results The positive rate of anti-HAV IgM was 0.19%,47 cases were HBV surface antigen-positive,accounted for 8.99%,183 cases were HBV surface antibody-positive,accounted for 35.00%,224 cases were all negative HBV markers,accounted for 42.83%.The quantitive detection of HBV surface-antibody in high concentration was significant higher than middle concentration and low concentration (all P < 0.05).The positive rate of anti-HCV IgG was 1.34%,anti-HDV IgG was all negative.The positive rate of anti-HEV IgM was 0.57%.The positive rate of anti-HEV IgG was 24.28%.With the advance of age,the positive rate of anti-HEV IgG had an increasing trend,with significant difference among groups (P < 0.05).Conclusion There are important significances in the detection of hepatitis virus markers in pregnancy monitoring,it can improve the quality of the population.
الملخص
Objective To investigate the diagnostic value of detection of protein SP70 in differentiating benign and malignant pleural effusion.Methods A case-control study was conducted from July 2011 to February 2012.108 cases of pleural effusion from patients with clinically proven lung cancers and 122 cases of benign pleural effusion were collected.SP70 was detected by Sandwich ELISA,while CEA,CYFRA21-1,NSE were measured by electrochemiluminescence immunoassay for comparison.Meanwhile,protein SP70 on exfoliated cells in pleural effusion was detected by direct immunofluorescence,and was compared with the results of HE staining.The differences between the groups were evaluated by the chisquare test Fisher' s exact test.Results Positive rates of SP70,CEA,CYFRA21-1,NSE were 72.2%,58.3%,52.8% and 30.6% in malignant pleural effusion,obviously higher than benign pleural effusio (9.8%,13.1%,23.0% and 19.7%).The specificity of SP70,CEA,CYFRA21-1,NSE were 90.2%,86.9%,77.0% and 80.3%,NSCLC had significantly higher positive rate than SCLC(74.3% >0.0%,P =0.02 < 0.05),detection of protein SP70 in malignant pleural effusion had significantly higher coincidence rate than HE staining(72.2% vs 47.2%,x2 =14.03,P < 0.05).Conclusion Determination of the protein SP70 in pleural effusion and in exfoliated cells,can improve the sensitivity and specificity of the diagnosis of malignant pleural effusion.