Hospitalization expenses of adult leukemia patients with relapse based on quantile regression / 公共卫生与预防医学

Objective Based on quantile regression analysis, the influencing factors of relapse hospitalization expenses of adult leukemia patients were analyzed. Methods Analyze the composition and influencing factors of hospitalization expenses for leukemia recurrence patients in our hospital. Results From 2017 to 2022 , the per capita hospitalization cost for leukemia patients with recurrence showed an increasing trend year by year. The results of quantile regression model showed that age, payment method , length of stay, times of stay, operation and complications had an impact on the hospitalization expenses of patients at different quantiles, and the difference between different quantiles was statistically significant (P<0.05). Conclusions The quantile regression method can more clearly reflect the distribution of the variables of each factor , we can reduce the hospitalization expenses of patients by improving the coverage rate of medical insurance and controlling the length of stay.

Self-reported quality of life in patients with coronary heart disease and analysis of the associated factors / 中华内科杂志

Objective: To investigate the quality of life and associated factors in patients with coronary heart disease (CHD) in China. Methods: A cross-sectional study of 25 provinces and cities in China was performed from June to September 2020. A questionnaire was used to collect the socio-demographic and clinical information of patients with CHD, while the European Five-dimensional Quality of Life Scale (EQ-5D) was used to assess the quality of life. Multiple linear regression model was performed to analyze the associated factors. Results: The median age of the 1 075 responders was 60 (52, 67) years, and 797 (74.1%) were men. The EQ-5D and EQ-VAS indices were 0.7 (0.5, 0.8) and 60.0 (40.0, 80.0). Among the five dimensions in the quality of life scale, the frequency of anxiety/depression was the highest (59.8%), while problems in self-care was the lowest (35.8%). In the multiple linear regression model, female, increasing age, obesity, comorbidity(ies), anxiety/depression, social media channels, and receiving the CABG therapy were associated with the lower EQ-5D index (all P<0.05). In addition, increasing age, obesity, comorbidity (ies), depression, anxiety and depression, social media channels, and receiving the CABG therapy were associated with lower EQ-VAS index (all P<0.05). Conclusion: Over half of the patients with CHD in China have a low quality of life, which is related to gender, age, obesity, treatment pathway, the presence or absence of comorbidity (ies), and psychological state. In addition to managing the adverse effects of traditional socio-demographic factors on the quality of life, clinical practices should pay attention to the psychological state of patients. Moreover, establishing a WeChat group for doctor-patient communication could improve the quality of life of CHD patients.

Caspase-1/-11 participates in LPS-induced sepsis-associated acute kidney injury by cleaving GSDMD / 生理学报

The present study was aimed to investigate whether Gasdermin D (GSDMD)-mediated pyroptosis participated in lipopolysaccharide (LPS)-induced sepsis-associated acute kidney injury (AKI), and to explore the role of caspase-1 and caspase-11 pyroptosis pathways in this process. The mice were divided into four groups: wild type (WT), WT-LPS, GSDMD knockout (KO) and KO-LPS. The sepsis-associated AKI was induced by intraperitoneal injection of LPS (40 mg/kg). Blood samples were taken to determine the concentration of creatinine and urea nitrogen. The pathological changes of renal tissue were observed via HE staining. Western blot was used to investigate the expression of pyroptosis-associated proteins. The results showed that the concentrations of serum creatinine and urea nitrogen in the WT-LPS group were significantly increased, compared with those in the WT group (P < 0.01); whereas serum creatinine and urea nitrogen in the KO-LPS group were significantly decreased, compared with those in the WT-LPS group (P < 0.01). HE staining results showed that LPS-induced renal tubular dilatation was mitigated in GSDMD KO mice. Western blot results showed that LPS up-regulated the protein expression levels of interleukin-1β (IL-1β), GSDMD and GSDMD-N in WT mice. GSDMD KO significantly down-regulated the protein levels of IL-1β, caspase-11, pro-caspase-1, caspase-1(p22) induced by LPS. These results suggest that GSDMD-mediated pyroptosis is involved in LPS-induced sepsis-associated AKI. Caspase-1 and caspase-11 may be involved in GSDMD cleavage.

Association of Dietary Diversity with Growth and Development of Children in Multi-ethnic Rural Areas of Sichuan Province / 中国医学科学院学报

Objective To understand the growth and dietary diversity status of children in multi-ethnic areas of Sichuan province,and to explore the associations of dietary diversity with growth and development indicators. Methods Children of 18-36 months old and their primary caregivers were selected with multi-stage cluster random sampling method from rural areas of Han,Tibetan,and Yi ethnic groups in Sichuan province. The sociodemographic information of children and their caregivers was collected using self-designed questionnaire.The dietary diversity score(DDS)was calculated according to the criteria in the Guidelines for Measuring Household and Individual Dietary Diversity released by the Food and Agriculture Organization of the United Nations.The body height(length)and body weight of each child were measured by standard equipment for anthropological measurement,and the height for age Z score(HAZ),weight for age Z score(WAZ),and weight for height Z score(WHZ) were calculated.Multivariate linear regression was performed to analyze the relationship between dietary diversity and growth indicators of children. Results A total of 1092 children were enrolled in this study,and the prevalence of stunting(HAZ<-2),underweight(WAZ<-2),and wasting(WHZ<-2)was 21.1%,4.9%,and 2.5%,respectively.The children had the mean DDS of 4.8±1.7,and 45.3% of children had poor dietary diversity(DDS≤4).The children of Han ethnic group(5.8±1.4)had higher DDS than those of Tibetan ethnic group(4.9±1.6)and Yi ethnic group(3.9±1.6)(P<0.001).The results of multivariate linear regression indicated that DDS was positively correlated with HAZ(β=0.206,95%CI=0.158-0.254,P<0.001)after adjustment of sex,age,birth weight,preterm birth,and parental body height.After further adjustment of family fixed assets,ethnic group,caregiver's type,and caregiver's education background,the correlation between DDS and HAZ remained significant(β=0.077,95%CI=0.026-0.128, P=0.003). Conclusions The children in the multi-ethnic rural areas of Sichuan province showed troublesome growth and development status and low dietary diversity,which were conspicuously different between ethnic groups,especially in the rural areas of Yi ethnic group.The dietary diversity was positively associated with HAZ.It is recommended to carry out nutrition and health education according to the local dietary characteristics and thus improve the growth and development of children in multi-ethnic rural areas in Sichuan.

Advance in Spexin in metabolic diseases and feeding behavior / 国际儿科学杂志

Spexin is a new cytokine with a short peptide of 14 amino acids encoded by Ch12orf39, which can be identified by bioinformatics technology.The sequence of Spexin is widely expressed in various organs and is conserved during vertebrate evolution.The physiological effects of Spexin are getting increasing attention in recent years.The studies suggest Spexin plays multiple physiological functions, and the main ligands for biological effects are galanin receptor type 2 and galanin receptor type 3.Spexin palys an important biological role in energy metabolism and homeostasis, cardiovascular function and feeding behavior, and even can affect the regulation of pain and depression relief and reproductive function.This review aims to systemically summarize the Spexin and its related biological functions in metabolic diseases and feeding behavior.

Co-culture of Neural Stem Cells and Spinal Cord Acellular Scaffold in Vitro / 中国康复理论与实践

Objective:To observe the adhesion, growth and differentiation of rat neural stem cells (NSCs) on spinal cord acellular scaffold (SCAS) to evaluate its feasibility for spinal cord tissue engineering. Methods:NSCs derived from neonatal Sprague-Dawley rat cerebral cortex were cultured and identified. SCAS were prepared from female Sprague-Dawley rat spinal cord tissues using modified chemical extraction and physical oscillation, and evaluated. The third generation NSCs were planted on SCAS and co-cultured, the morphology of the cells on the scaffold was observed with immunofluorescence, immunohistochemistry and scanning electron microscope. Results:The cultured cells were NSCs, which could proliferate and differentiate. The porosity, water content and enzymatic hydrolysis rates of the prepared SCAS were significantly higher than that of normal spinal cord (|t| > 4.679, P < 0.01). The matrix structure of SCAS was loosely network-like, with few residual nuclei. NSCs adhered and grew well, and differentiated into neurons and glial cells on SCAS. Conclusion:This kind of SCAS shapes multi-channel spatial structure and is suitable for NSCs adhesion, growth and differentiation, which can be used for spinal cord tissue engineering.

Effect of C21 steroidal glycoside of Cynanchum auriculatum on liver and kidney fibrosis through TLR4 pathway / 中国中药杂志

The liver and kidney fibrosis model was established by thioacetamide(TAA) and unilateral ureteral obstruction(UUO) in SD rats. The rats were randomly divided into three groups: model group, low and high-dose groups of C21 steroidal glycosides of Cynanchum auriculatum. Another blank control group was set. Four weeks later, serum was taken to detect the biochemical indexes of liver and kidney function. Urine protein and urine creatinine were detected by kits. Liver and kidney tissue samples were stained with HE and Masson staining, and hydroxyproline content was detected. Western blot was used to detect expressions of fibrotic proteins, inflammatory factors and TLR4 signaling pathways, so as to observe the preventive and therapeutic effects of C21 steroidal glycosides from C. auriculatum on hepatic and renal fibrosis and explore its molecular mechanism. Four weeks later, serum biochemical results showed that liver and kidney functions were seriously damaged, and pathological sections showed that inflammatory cell infiltration, decrease of parenchymal cells, and increase of interstitial fibrosis in liver and kidney tissues. The results showed that low and high doses(150, 300 mg·kg~(-1)) of C21 steroidal glycosides could significantly reduce the collagen deposition and the pathological changes of liver and kidney fibrosis compared with the model group. At the same time, we found that the expression levels of TLR4 and MyD88 signaling pathway proteins were significantly increased in the liver and kidney tissues of the model group, and a large number of NF-κB signaling pathway proteins migrated into the nucleus. On the contrary, the expression levels of TLR4, MyD88 signaling pathway proteins and the nuclear migration of NF-κB were significantly inhibited in the low and high dose groups of C21 steroidal glycosides from C. auriculatum. Therefore, it was speculated that the mechanism of C21 steroidal glycoside for preventive and therapeutic effect on hepatic and renal fibrosis was related to inhibit TLR4/MYD88/NF-κB inflammatory pathway, thus preventing hepatic and renal fibrosis.

Dietary fiber intake and its correlation with cardiac event-free survival in patients with heart failure / 中华临床营养杂志

Objective:To investigate the daily dietary fiber intake, the main adverse cardiovascular events during follow-up and the cardiac event-free survival in patients with chronic heart failure, and to analyze the relationship between dietary fiber intake and cardiac event-free survival in this population.Methods:This study was a prospective investigation. The investigation was performed in chronic heart failure patients from three third-class hospitals in Suzhou using general information questionnaire and 3-day diet diary. Major adverse cardiovascular events within 6 months after discharge and event-free survival were obtained by telephone call and medical records.Results:The incidence of major cardiovascular adverse events in 122 patients with heart failure was 27.9% within 6 months after discharge. Their dietary fiber intake was 8.1(5.8-10.9)g/d, lower than the recommended intake. Kaplan-Meier plots and log-rank tests demonstrated that cardiac event-free survival was significantly shorter in patients with dietary fiber deficiency ( P=0.043). Patients with dietary fiber intake ≥6 g/d after discharge showed decreased risk of major adverse cardiovascular events compared to patients with dietary fiber intake<6 g/d ( HR=0.422; 95% CI=0.189-0.942; P=0.035). Conclusions:This study revealed insufficient dietary fiber intake in patients with heart failure. Insufficient dietary fiber intake was associated with higher risk of major adverse cardiovascular events and shorter cardiac event-free survival in heart failure patients within 6 months after discharge. In conclusion, patients with heart failure can increase dietary fiber intake in order to improve prognosis.

Prediction of gene mutation in lung cancer based on deep learning and histomorphology analysis / 生物医学工程学杂志

Lung cancer is a most common malignant tumor of the lung and is the cancer with the highest morbidity and mortality worldwide. For patients with advanced non-small cell lung cancer who have undergone epidermal growth factor receptor (EGFR) gene mutations, targeted drugs can be used for targeted therapy. There are many methods for detecting EGFR gene mutations, but each method has its own advantages and disadvantages. This study aims to predict the risk of EGFR gene mutation by exploring the association between the histological features of the whole slides pathology of non-small cell lung cancer hematoxylin-eosin (HE) staining and the patient's EGFR mutant gene. The experimental results show that the area under the curve (AUC) of the EGFR gene mutation risk prediction model proposed in this paper reached 72.4% on the test set, and the accuracy rate was 70.8%, which reveals the close relationship between histomorphological features and EGFR gene mutations in the whole slides pathological images of non-small cell lung cancer. In this paper, the molecular phenotypes were analyzed from the scale of the whole slides pathological images, and the combination of pathology and molecular omics was used to establish the EGFR gene mutation risk prediction model, revealing the correlation between the whole slides pathological images and EGFR gene mutation risk. It could provide a promising research direction for this field.

Cloning and functional characterization of farnesyl diphosphate synthase in Senecio scandens / 中国中药杂志

As a secondary metabolite, sesquiterpenes are not only have important functions in plant defense and signaling, but also play potential roles in basic materials for pharmaceuticals, cosmetic and flavor. As a traditional Chinese herbal medicine, Senecio scandens exhibits effects of anti-inflammatory and immunosuppressive, as well as invigorating the blood and removing extravasated blood. Over 600 sesquiterpenes with diverse structures were isolated from S. scandens and related species in the same genus. To characterize sesquiterpenes synthesis, two FPS genes(SsFPS1 and SsFPS2) were identified in S. scandens through transcriptomic analysis. Bioinformatic analysis showed that both SsFPSs have conserved motifs for FPS function. Both SsFPSs exhibited constitutive gene expression in S. scandens tissues and SsFPS2 accumulated higher transcript in leaves and roots than SsFPS1. Meanwhile consistent with constitutive sesquiterpene accumulation in S.scandens tissues, most of these sesquiterpenes were detected in leaves and roots more than stems and flowers. Recombinant expression through Escherichia coli metabolic engineering, SsFPS1 or SsFPS2 was co-transformed with ZmTPS11(maize β-macrocarpene synthase) into BL21 competent cells. The results showed that the content of β-macrocarpene was increased by co-transformation with SsFPSs. It is demonstrated that SsFPS1 and SsFPS2 catalyzed E,E-FPP formation and provided FPP precursor for downstream sesquiterpene synthases. Characterization of SsFPSs provided the foundation for the exploration of biosynthesis of sesquiterpenoid with diverse structures and potential pharmaceutical values in S.scandens, and provide an important theoretical basis for the development of S. scandens abundant resources.

Identification of stable reference gene by qRT-PCR in Senecio scandens / 中国中药杂志

As a traditional Chinese medicine, Senecio scandens is rich in important compounds such as flavonoid and sesquiterpenoid. Based on the transcriptome data of S. scandens, 15 candidate reference genes were selected including ABCT, ACT1, ACT2, ACT3, ACBP, ARF, ATPS, EF-H, EF-1α, ETIF, GAPDH, GTPB, MPS, UCE and 60S. Firstly, 9 candidate genes with relatively stable expressions such as ACT1, ACBP, ARF, ATPS, EF-1α, GAPDH, MPS, UCE and 60S were screened from different tissues of S. scandens by RT-PCR. Then, qRT-PCR was used to quantitatively analyze gene expression of these nine candidates in S. scandens with or without stress treatments. Further analysis of these gene expression data by geNorm and NormFinder showed that ACT1 exhibited the stablest expression in all samples and could serve as a reference gene for future study of S. scandens, and provide an endogenous control for gene expression analysis.

Functional characterization of SsNES responsible for nerolidol biosynthesis in Senecio scandens / 中国中药杂志

A short terpene synthase gene was obtained by screening the transcriptome data of Senecio scandens. The phylogenetic tree and sequence alignment putatively identified this gene as a nerolidol synthase gene, named SsNES(GenBank MH518312). Protein homology modeling indicated that SsNES contained a complete conserved domain and folded correctly. SsNES was cloned and successfully expressed in Escherichia coli as soluble protein. The biochemical function of SsNES was characterized by E. coli metabolic engineering, which showed that SsNES catalyzed formation of trans-nerolidol with(E, E)-farnesyl diphosphate as the substrate. Nerolidol was also detected in stems and leaves of S. scandens, indicating that SsNES might act as the nerolidol synthase in plant. RT-PCR analysis indicated that SsNES was mainly expressed in stem, flowers and leaves, and no expression was observed in roots. After the treatment of SA, MeJA or Ala, SsNES was induced significantly at 6 h, indicating involvement in the defense response of S. scandens. The identification of SsNES not only clarified biosynthesis of nerolidol in S. scandens, but also provided diversity of sesquiterpene synthase, as well as theoretical basis for disease and pest defense mediated by the terpene metabolites.

Efficiency of γ-glutamyl transpeptidase to platelet ratio for diagnosis of liver fibrosis in chronic hepatitis B patients / 第二军医大学学报

Objective: To investigate the diagnostic efficiency of γ-glutamyl transpeptidase to platelet ratio (GPR) for detecting liver fibrosis in chronic hepatitis B patients, and to compare its efficiency with those of liver stiffness measurement (LSM) value, asperate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4). Methods: We retrospectively included patients with chronic hepatitis B who had undergone surgery or liver biopsy in our hospital from May 2015 to Sep. 2015. All patients had undergone transient elastography to record LSM value and serological examination to calculate GPR, APRI and FIB-4 before surgery or liver biopsy. The diagnostic efficiency of each index was evaluated by receiver operating characteristic (ROC) curve and the area under ROC curve was compared. Results: Totally 260 patients were eventually enrolled in the present study, including 213 males and 47 females, with the average age being (53.49±9.78) years and the average BMI being (23.36±3.06) kg/m2. GPR, LSM value, APRI and FIB-4 were moderately correlated with S≥2 and S4 liver fibrosis (all P0.05). Conclusion: It has been indicated that GPR, LSM value, APRI and FIB-4 have diagnostic accuracy for S≥2 and S4 liver fibrosis. The diagnostic accuracy of LSM value and GPR for S≥2 and S4 liver fibrosis is better than that of FIB-4, and that of LSM value for S4 liver fibrosis is better than that of APRI. Therefore, GPR and LSM value may serve as the optimal indexes for noninvasively evaluating liver fibrosis in chronic hepatitis B patients.

Advance in Whole Body Periodic Acceleration for Cardiovascular System (review) / 中国康复理论与实践

As a novel intervention, whole body periodic acceleration (WBPA) shows a variety of benefits to the cardiovascular system, such as reducing pulmonary arteria hypertension (PAH), improving coronary flow reserve (CFR) and increasing blood perfusion of organs as well as tissues. The underlying mechanisms of WBPA may lie in the increase of blood flow rate and endothelium shear stress, activation of phosphoinositide 3-kinase/serine threonine kinase (PI3K-Akt) and mitogen extracellular signal regulated kinases/extracellular signal regulated kinase (MEK-ERK1/2) signal pathway and the release of nitric oxide.

Effect of transcranial direct current stimulation on emotional face perception over brain right dorso-lateral prefrontal cortex in college students / 中华行为医学与脑科学杂志

Objective To investigate whether modulating the activation of dorsolateral prefrontal cortex(DLPFC) by transcranial direct current stimulation(tDCS) can influence emotional perception. Meth-ods Seventy-eight undergraduates were randomly divided into four groups by simple random sampling meth-od. TDCS (1. 5 mA) noninvasive technique was used to test group 1 (n=23) for 3 minutes to intervene in DLPFC,group 2 (n=17) for 15 minutes to intervene in DLPFC,group 3 (n=20) for 3 minutes to intervene in primary visual cortex,and group 4 (n=18) for non-emotional picture test. The data were analyzed with re-peated measurement variance analysis. Results (1) The interaction between short-term(3 min) stimula-tion of tDCS and facial expression was statistically significant (F(1,22)=7. 448,P=0. 012). There was signifi- cant difference in positive face perception (before:70. 58%,period:74. 75%,P=0. 036) and no significant difference in negative face perception (before:70. 58%,period:70. 73%,P=0. 569). (2) There was no sig-nificant difference in the correlation between prolonged tDCS stimulation(15 min) and face expression recog-nition ( F (1,16)= 1. 621, P=0. 221). (3) The primary visual cortex was not affected by anodal tDCS (F(1,19)<1,P>0. 05). (4) There was no significant difference in the interaction between tDCS and facial ex-pression (F(1,17)=2. 566,P=0. 128) when visual stimulus was changed to non-expressive faces. Conclu-sions By applying tDCS technique,the present findings suggest that modulating DLPFC can influence emo-tional face perception,and support the valence-specific lateralization of emotional perception.

Efficacy and Safety of Gabapentin in the Treatment of Chronic Cough: A Systematic Review / 결핵및호흡기질환

Despite recent clinical guidelines, the optimal therapeutic strategy for the management of refractory chronic cough is still a challenge. The present systematic review was designed to assess the evidence for efficacy and safety of gabapentin in the treatment of chronic cough. A systematic search of PubMed, Embase, Cochrane Library databases, and publications cited in bibliographies was performed. Articles were searched by two reviewers with a priori criteria for study selection. Seven relevant articles were identified, including two randomized controlled trials, one prospective case-series designed with consecutive patients, one retrospective case series of consecutive patients, one retrospective case series with unknown consecutive status, and two case reports comprising six and two patients, respectively. Improvements were detected in cough-specific quality of life (Leicester Cough Questionnaire score) and cough severity (visual analogue scale score) following gabapentin treatment in randomized controlled trials. The results of prospective case-series showed that the rate of overall improvement of cough and sensory neuropathy with gabapentin was 68%. Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed.

Expression of COX-1 and COX-2 in the Platelet of Iron Deficiency Anemia Women at Childbearing Age and Its Clinical Significance / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect the expression level of cyclooxygenase-1（COX-1） and cyclooxygenase-2（COX-2） in the platelet of iron deficiency anemia（IDA）women at childbearing age and to explore its correlation with the different indexes of anemia and platelets.</p><p><b>METHODS</b>Forty female IDA patients at childbearing age and 35 healthy controls were enrolled in this study. The Flow cytometry was used to detect the expression of platelet COX-1 and COX-2，the platelet aggregation function as examined by turbidimetric method，and the levels of serum ferritin were analyzed by electrochemical luminescence method，the leval of serum iron was determined by ELISA，and the correlation of different indexes was analyzed.</p><p><b>RESULTS</b>Compared with healthy controls，the levels of platelet COX-1 and COX-2 were significantly lower in female IDA patients at Childbearing age（P<0.05），but platelet count（Plt），mean platelet volume（MPV） and platelet aggregation rate（PAgT）were not statistically different between the 2 groups（P > 0.05）. The expression level of platelet COX-1 positively correlated with those of Hb（r =0.623，P<0.01），serum iron（r =0.321，P<0.05） and HCT（r=0.305，P<0.05）. but the platelet COX-2 expression did not corelate with these indexs.</p><p><b>CONCLUSION</b>The expression of platelet COX-1 and COX-2 in female IDA patients at Childbearing age markedly decrease，and the expression level of platelet COX-1 closely relates with the severity of anemia，that possesses reference value for clinical diagnosis of female IDA patients at Childbearing age..</p>

Study of Anti-tumor Effect of Jianpi Huoxue Prescription on SMMC-7721 Hepatoma Mice / 中国中医药信息杂志

Objective To observe the effects of Jianpi Huoxue Prescription on the subcutaneous transplantation of tumor cell apoptosis and angiogenesis; To discuss its possible mechanism of action. Methods SMMC-7721 hepatoma mice models were established. 60 tumor bearing male mice were randomly divided into blank group, model group, 5-Fu group, Jianpi Huoxue Prescription high-, medium- and low-dosage groups, with 10 rats in each group. Model group and Jianpi Huoxue Prescription high-, medium- and low-dosage groups were given medicine with relevant concentrations for gavage, once a day. 5-Fu group was given 5-Fu for intraperitoneal injection every other day. The weight, tumor weight and tumor inhibitory rate of each group were compared two weeks later. The protein expressions of VEGF and VEGFR-2 were detected by immunohistochemistry, microvessel density (MVD) were calculated, and the expressions of Survivin and Caspase-3 mRNA were detected by RT-qPCR. Results Compared with model group, protein expressions of VEGF and VEGFR-2, MVD, Caspase-3 and Survivin mRNA decreased in Jianpi Huoxue Prescription high-, medium- and low-dosage groups, and the most obvious differences were in 5-Fu group and Jianpi Huoxue Prescription high-dosage group (P<0.05). Conclusion Jianpi Huoxue Prescription can inhibit tumor growth by inhibiting angiogenesis and inducing apoptosis.

Lung non-terminal respiratory unit type adenocarcinoma: a clinicopathologic study / 中华病理学杂志

Objective@#To evaluate the clinicopathologic characteristics of lung non-terminal respiratory unit (non-TRU) type adenocarcinoma.@*Methods@#Seventy-two cases of lung non-TRU type adenocarcinoma that underwent complete resection and diagnosed at Departments of Pathology, Affiliated Suzhou Hospital of Nanjing Medical University and Nanjing General Hospital of the PLA from January 2005 to December 2016 were retrospectively studied. The histomorphological changes and precursor lesions were observed under microscope. The expression of lineage-specific markers and tumor stem cell markers was detected by immunohistochemistry (IHC). The major driver mutations of lung adenocarcinoma were tested by ARMS and directive gene sequencing.@*Results@#Non-TRU type adenocarcinomas were more commonly found in male (65.3%, 47/72), former or current smokers (68.1%, 49/72), the elder (mean 61 years old), central adenocarcinoma (75.0%, 54/72), tumors with necrosis (61.1%, 44/72) and higher grade (73.6%, 53/72). Histologically, non-TRU type adenocarcinoma displayed complex histomorphology and was often composed of large irregular gland-like and acinar pattern accumulating extracellular mucin, necrotic tumor cell debris and neutrophils, or invasive adenocarcinoma with mucin production. The tumor cells were composed of bronchial surface epithelial cells, mucinous column cells, polygonal cells and goblet cells. Eighteen (25.0%), 23 (31.9%) and 28 (38.9%) cases exhibited ciliated columnar cell metaplasia (CCCM), mucous columnar cell change (MCCC) and bronchiolar columnar cell dysplasia (BCCD) (precursor lesion of lung adenocarcinoma). IHC showed the expression of CK7 (100.0%, 72/72), TTF1 (12.5%, 9/72), Napsin A (5.6%, 4/72), MUC5AC (81.9%, 59/72), MUC5B (87.5%, 63/72), p53 (66.7%, 48/72), CK5/6 (12.5%, 9/72), p63 (18.1%, 13/72), CK20 (19.4%, 14/72) and CDX2 (16.7%, 12/72) in the tumor cells. The expression of tumor stem cell markers was detected in 43.1% cases (31/72) for CD44, 31.9% (23/72) for CD133, 58.3% (42/72) for β-catenin, 36.1% (26/72) for ALDH1, 12.5% (9/72) for GATA6, 20.8% (15/72) for SOX2 and 29.2% (21/72) for OCT4. The driver mutations were 26.4% (19/72) for KRAS, 2.8% (2/72) for EGFR and 1.4% (1/72) for EML4-ALK, and none for BRAF and ROS1.@*Conclusion@#Non-TRU type adenocarcinoma is an uncommon subtype of lung adenocarcinoma with distinct clinicopathologic characteristics, histologic appearances, immunophenotype and molecular genetic alterations.

Optimism and resilience in patients with breast cancer: chain mediating effect of mastery and self-efficacy / 中华行为医学与脑科学杂志

Objective To explore the chain mediating effect of mastery and self-efficacy between optimism and resilience of breast cancer patients.Methods Totally 262 breast cancer patients were investigated with general information questionnaire,resilience scale (RS-14),mastery scale for Chinese version (MSC),general self-efficacy scale (GSES) and revised life orientation test (LOT-R).Causual steps and Bootstrap method were used to test the chain mediating effect of mastery and self-efficacy between optimism and resilience.Results The media score of the participants was 18 for optimism,and the average score of the participants was 27.1±4.6 for mastery,26.0±5.9 for self-efficacy,76.6± 13.9 for resilience.There existed a significant difference in RS-14 scores among the patients with different family relationships,family income,and form of payment (all P＜0.05).Correlation analysis showed that optimism,mastery,self-efficacy,and resilience were positively correlated with each other(r=0.57-0.74,all P＜ 0.01).Mediation modeling analysis showed that optimism had a direct effect on resilience.The effect value was 0.361,and the effect was 49.7％.Mastery and self-efficacy mediation effect value were 0.123 and 0.162,and the mediation effect were 16.9％ and 22.3％.While chain mediating effect of mastery-self-effcacy was also significant,and the mediation effect value was 0.081 and the mediation effect was 11.1％.Conclusion Optimism influences breast cancer patients' resilience,not only through the direct path,but also through the indirect path of mastery and self-efficacy,as well as the chain mediating path between these two variables.