The relationship of circulating tumor cells in peripheral blood of pancreatic cancer patients with postoperative recurrence and prognosis / 中华胰腺病杂志

Objective To detect circulating tumor cells (CTCs) in the peripheral blood of patients with pancreatic cancer using a new nano microfluidic chip and to explore the relationship between CTCs and clinicopathological feature,postoperative recurrence and prognosis of pancreatic cancer.Methods The peripheral blood samples of 53 patients with pancreatic cancer who underwent curative resection in the second affiliated hospital of Jiaxing college of medicine were collected from January 2015 to January 2017.The CTCs from peripheral blood were detected by novel nano microfluidic chip.The cut-off value for CTCs-positive and negative groups was 1 CTC.The relationship between CTCs positive and postoperative recurrence and prognosis of pancreatic cancer were evaluated.Results The number of CTCs for 23 pancreatic cancer of 53 patients ranged from 5 to 196 per ml,and the mean number was 78.5 ± 44.7 per ml;the rate of CTCs-positive patients was 43.4％ (23/53).There were significant correlation between CTCs with vascular invasion (P =0.001),but but CTCs was not correlated with the gender,age,the presence of clinical symptoms,tumor size,pathological type,lymph metastasis and TNM stage.31 patients had tumor recurrence,and the rate of tumor recurrence was 58.5％.Among them,there were 13 cases with tumor local recurrence,10 cases with tumor distant metastasis (including liver,lung,kidney,etc.) and 8 cases with both tumor local recurrence and distant metastasis.The median recurrence free survival time of all patients was 14.0 months (13.0-17.0) and the median overall survival time was 19.0 months (15.5-24.0).The cumulative one-year and two-year recurrence free survival rate were 66.9％,12.2％ for patients with CTCs-positive and 88.3％,42.2％ for CTCs-negative patients,and the differences were statistically significant (both P ＜ 0.05).The cumulative one-year and two-year overall survival rate were 85.4％,33.6％ for patients with CTCs-positive and 96.3％,62.2％ for CTCs-negative.There was no difference in statistics in cumulative one-year overall survival rate and with a statistically significant difference in cumulative two-year overall survival rate (P =0.028).Conclusions Peripheral blood CTCs of pancreatic cancer can be effectively detected by a novel nano microfluidic chip.There were significant correlation between CTCs with vascular invasion and survival time after surgery.CTCs may be a potential prognostic indicator of the postoperative recurrence and prognosis of pancreatic cancer.

Relationships between peripheral circulating tumor cells in patients with gallbladder carcinoma detected by a novel nano microfluidic chip with clinicopathology and prognosis / 中华肝胆外科杂志

Objective To establish a novel method using a nano microfluidic chip to detect circulating tumor cells (CTCs) in peripheral blood in gallbladder carcinoma,and to study the relationship between CTCs with clinicopathology and prognosis in these patients.Methods The peripheral blood samples of 51 patients with gallbladder carcinoma were collected from June 2014 to January 2017.The CTCs from peripheral blood samples were detected by a novel nano microfluidic chip.This study aimed to study the correlation between CTCs with the clinical and pathological features.The significance of CTCs on prognosis in patients with gallbladder carcinoma was also analyzed.Results The positive rate of CTCs in the peripheral blood of gallbladder carcinoma patients was 43.1％ (22/51).There were significant correlations between CTCs with liver metastasis (P ＜ 0.05) and Nevin staging (P ＜ 0.05).The 1-and 2-year overall survival (OS) in patients with CTCs were 70.7％ and 35.3％,and the 1-and 2-year OS in patients without CTCs were 92.0％ and 56.1％.There was a significant difference in the 2-year OS (P ＜ 0.05) but no significant difference in the 1-year OS between the 2 groups of patients (P ＞ 0.05).Conclusions Peripheral blood CTCs in patients with gallbladder carcinoma were efficaciously detected by a novel nano microfluidic chip.Peripheral blood CTCs was closely related to the Nevin staging and liver metastasis.CTCs could serve as a potential prognostic indicator in patients with gallbladder carcinoma.

The diagnostic value of the K-ras mutation detection of endoscopic ultrasound-guided fine needle aspiration specimen for pancreatic carcinoma / 中华胰腺病杂志

Objective To explore the diagnostic value of k ras mutation detection of specimen obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA)for pancreatic cancer.Methods Seventy-eight patients with pancreatic carcinoma and 49 patients with pancreatic benign diseases were collected from January 2013 to December 2015.All the patients underwent EUS-FNA and cell or tissue samples were collected.DNA was extracted from the samples,and the codon 12 and 13 mutation of K-ras gene was detected by specific nano capture probe.Liquid cytology was also conducted.The sensitivity and specificity of the two methods were compared.Results The K-ras mutation rate was 92.3％ (72/78) in 78 patients with pancreatic carcinoma,which was obviously higher than the mutation rate of 20.4％ (10/49) in 49 patients with pancreatic benign tumors,and the difference was statistically significant (x2 =68.002,P =0.000).The sensitivity of the cytology examination of EUS-FNA specimens in the diagnosis of pancreatic carcinoma was 75.6％,the specificity was 87.8％,Youden index was 0.634,the positive and negative predictive value was 6.196 and 0.227.The detection of K-ras mutations had a sensitivity of 92.3％ and a specificity of 79.6％ in the diagnosis of pancreatic carcinoma,the Youden index was 0.719,the positive and negative predictive value was 4.524 and 0.096.K-ras mutation detection had a higher sensitivity compared with cytology,and the difference was statistically significant (x2 =8.47,P =0.004).The sensitivity was 94.9％ and specificity of 95.9％ using the combination of K-ras mutations and cytology for diagnosing pancreatic cancer,and the specificity was obviously increased compared with only k ras mutation detection and the difference was statistically significant (x2 =6.13,P =0.013).Conclusions K-ras mutation detection of EUS-FNA specimen using nano capture probe system can significantly improve the sensitivity of diagnosing pancreatic cancer,and the sensitivity and specificity could be further improved when combined with cytology.

The study on the diagnostic and prognostic value of detecting K-ras mutations in plasma of patients with pancreatic cancer by a novel nano capture probe / 中华胰腺病杂志

Objective To detect K-ras mutations in plasma by a nano capture probe system , and to explore the diagnostic and prognostic value of this method for patients with pancreatic cancer .Methods The clinical data of 62 patients with pancreatic cancer , 38 patients with benign pancreatic diseases and 31 healthy controls admitted in the Second Affiliated Hospital of Jiaxing Medical College from June 2013 to June 2015 were collected.The diagnosis of all the patients were confirmed by pathology .The DNA were extracted from all plasma samples and were detected for the codon 12 and 13 mutation of K-ras gene by nano capture probe and conventional PCR plus direct sequencing .The correlation of K-ras gene mutation with certain clinical data and the diagnostic and prognostic value in pancreatic cancer were analyzed .Results The K-ras mutation were detected by nano capture probe in 27 pancreatic cancer patients , and the mutation rate was 43.5%(27/62), including 25 cases with codon 12 mutation and 2 cases with codon 13 mutation .The K-ras mutation rate in patients with benign pancreatic diseases was 7.9%(3/38), which were all in codon 12.K-ras mutation was detected in only 17 pancreatic cancer patients by conventional PCR plus direct sequencing , and the mutation rate was 27.4%(17/62), The K-ras mutation rate of benign pancreatic diseases was 5.3%(2/38).The mutation rate detected by nano capture probe was higher than that by conventional PCR , and the difference was statistically significant (P=0.006).K-ras mutation in the plasma of patients with pancreatic cancer was related to TMN stage and liver metastasis , but there was no correlation of the factors such as sex , age, clinical symptoms, tumor size, serum CA19-9 and CEA levels with K-ras mutation.The sensitivity of K-ras gene mutation for diagnosing pancreatic cancer was 43.5%, the specificity was 92.1%, the positive predictive value was 90%, the negative predictive value was 50%, Youden index was 0.356.The 1-year survival rate of patients with K-ras mutation was 44.4%, which was lower than that (71.4%) of patients with wild-type K-ras, and the difference was statistically significant (P<0.05).Conclusions The nano capture probe system could certainly detect K-ras mutation in a small quantity of plasma DNA , and its diagnosis sensitivity for pancreatic cancer is low , but the specificity is relatively high .K-ras mutation in plasma is closely related to the TMN stage and prognosis of pancreatic cancer .

The distribution and resistance of bacteria isolated from infection department of children′s hospital / 国际检验医学杂志

Objective To investigate the distribution of pathogens isolated from clinical samples and the resistance to the com‐mon antimicrobial agents .Methods Of the 3 745 children ,Hand‐foot‐mouth disease was the most prevalent disease with 1 397 (37 .30% ) cases ,followed by the bronchopneumonia ,rotavirus enteritis and bacterial intestinal infection ;784 strains were isolated from the samples mainly including Haemophilus parainfluenzae (16 .20% ) ,Streptococcus pneumoniae (14 .92% ) ,Moraxella ca‐tarrhalis (12 .88% ) ,Staphylococcus aureus (10 .59% ) and Salmonella enterica(10 .8% ) ;The positive rate of Methicillin‐resistance Staphylococcus aureus(MRSA) was 27 .50% and the ESBLs producing Escherichia coli and Klebsiella pneumoniae were 46 .43%and 81 .40% ,and two or more pathogens could be isolated from sputum .Conclusion Haemophilu ,Streptococcus pneumonia and Moraxella catarrhalis are the main bacterial pathogens in the department of infectious .There is a certain resistance to the common antimicrobial agents .It is important for us to focus on the pathogens and we should pay more attention to the control the resistance of the bacteria .

Endothelial repairing function in patients with symptomatic middle cerebral arterial stenosis after stent implantation / 中华全科医师杂志

Objective To investigate the relation between endothelial repairing function and in-stent restenosis in patients with symptomatic middle cerebral arterial (MCA) stenosis after stent implantation.Method Sixty-six patients with symptomatic MCA stenosis underwent percutaneous stent implantation.Cranial CTA revealed that 23 patients had MCA restenosis (restenosis group) 1 year after stenting,including 14 cases with ＞50％ stenosis and 1 case with MCA occlusion,and 43 patients had no restenosis (non-restenosis group).The number of endothelial progenitor cells (EPC) was examined by flow cytometry,the adhesion function of EPC was tested by adhesion assay,the migration ability of EPC was tested by Transwell method and serum vascular endothelial growth factor (VEGF) levels were measured by ELISA.The relationship of endothelial repairing function with restenosis was analyzed.Results The MCA stent implantations were successfully performed in all patients.The EPC number (33.7 ± 4.6 vs.61.6 ± 6.4),adhesion activities (26.1 ± 7.5 vs.56.3-± 9.6),migration activities (12.0 ± 3.9 vs.21.4 ± 6.5) and serum VEGF level [(56.7 ± 14.6) vs.(89.6 ± 17.32) ng/L] in restenosis group were significantly lower than those in non-restenosis group (t =18.48,13.09,6.34 and 7.73,all P ＜ 0.05).Conclusion For patients with MCA stenosis after percutaneous stent implantation the increased risk of in-stent restenosis is associated with low level of EPCs and their migration ability,and low serum VEGF level.

Relation between serum high sensitive C-reactive protein and acute cerebral infarction and its degree of nervous function defect / 中国综合临床

Objective To investigate the changes of serum high sensitive C-reactive protein(hs-CRP) level in patients with acute cerebral infarction(ACI),and the relationship between serum hs-CRP level and ACI severity as well as subtypes according to Chinese Ischemic Stroke Subclassification(CISS)criteria. Methods The serum hs-CRP level in 256 patients with ACI and 196 normal controls were measured. The degree of nervous function defect in patients with ACI was assessed by the United States National Institutes of Health Stroke Scale ( NIHSS ) score. All patients were classified into five major ischemic stroke subtypes based on CISS criteria. Logistic regression analysis was applied to analyze the risk factors of ACI. Results The serum hs-CRP level in patients with ACI and control group were(4. 69 ± 2. 58)mmol/ L and(2. 13 ± 1. 79)mmol/ L,and the difference between groups was significant(t = 12. 439,P = 0. 000). The hs-CRP in patients with severity ACI (147 cases)were(5. 89 ± 4. 15)mmol/ L,significantly higher than that in patients with mild ACI,and the difference between groups was significant((2. 11 ± 1. 45)mmol/ L,t = 10. 230,P = 0. 000)). As for subtype ACI,the case of the large artery atherosclerosis subtypes was 106( 41. 57% ),highest than any other subtypes. The hs-CRP level of large artery atherosclerosis was(7. 01 ± 3. 12)mmol/ L,higher than that of control group( P = 0. 000). The logistic regression analysis showed that many factors were related to ACI including total cholesterol,homocysteine and high sensitive C-reactive protein( OR = 0. 324,0. 749,0. 809;P< 0. 05). Conclusion The serum hs-CRP level in patients with ACI increase significantly,and relate to the degree of neural function defect. The level of hs-CRP of large artery atherosclerotic stroke is the highest. The change of serum hs-CRP is very valuable to estimate the severity of ACI.

Relationship between high sensitive C-reactive protein and stroke subtype according to Chinese Ischemic Stroke Subclassification criteria in patients with acute cerebral infarction / 中华全科医师杂志

By analyzing the clinical data of 216 cases of acute cerebral infarction (ACI) from 2012 January to 2013 June retrospectively,we found that the serum levels of high sensitive C-reactive protein (hs-CRP) in patients were significantly higher than those in 186 controls (P ＜0.01).The degree of neural function defect in ACI patients was assessed by the National Institutes of Health Stroke Scale (NIHSS) score.The hs-CRP level of the patients with NIHSS score ＞ 8 were higher than that in those with NIHSS score ≤8 (P ＜ 0.05).The hs-CRP level of patients of large artery atherosclerosis were (6.32 ± 4.12) mg/L and the positive rate of hs-CRP was 85.7％ (84/98).All were respectively higher than those in patients of penetrating artery disease [(1.97 ±0.86) mg/L,7/71],cardiogenic stroke [(3.70 ± 2.76) mg/L,14/24],undetermined etiology [(3.43 ± 3.52) mg/L,5/11] and other etiologies [(3.41 ± 3.25) mg/L,5/12] (all P ＜ 0.05).Logistic regression analysis was performed for the risk factors of ACI.The correlative factors of ACI included hypertension,diabetes mellitus,atrial fibrillation,smoking,total cholesterol,homocysteine and high sensitive C-reactive protein (OR =1.56,1.19,1.23,1.17,3.08,1.34,1.25,all P ＜ 0.01).The serum levels of hs-CRP increased significantly in ACI patients and were correlated with the degree of neural function defect.