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BACKGROUND@#Immune checkpoint inhibitors (ICIs) therapy lacks viable biomarkers for response and prognosis prediction. This study aimed to investigate the correlation of peripheral blood laboratory test results combined with lymphocyte subset ratios to the response and prognosis of immunotherapy in advanced lung cancer.@*METHODS@#Advanced lung cancer patients admitted to West China Hospital, Sichuan University from May 2021 to July 2023 were prospectively enrolled in this study. Clinical data and peripheral blood were collected before and after treatment and lymphocyte subset ratios were analyzed by flow cytometry. Logistic regression was used to identify factors correlated to ICIs treatment efficacy. Cox modeling was applied to explore the prognostic factors.@*RESULTS@#Logistic regression showed that the baseline level of transcription factor T cell factor 1 (TCF1)+CD8+ T cell ratio and peripheral white blood cell (WBC) count, lymphocyte percentage, cytokeratin 19 fragment (CYFRA21-1) after 1 cycle of ICIs treatment were the potential predictors for ICIs response (P<0.05). Cox regression analysis showed that the baseline level of TCF1+CD8+ T cell ratio (P=0.020) and peripheral WBC count after 1 cycle of ICIs treatment (P<0.001) were prognostic factors.@*CONCLUSIONS@#Patients with high baseline TCF1+CD8+ T cell ratio combined with low WBC counts and low CYFRA21-1 level after 1 cycle of ICIs treatment are more likely to benefit from ICIs therapy.
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Humans , Lung Neoplasms/drug therapy , Carcinoma, Non-Small-Cell Lung/drug therapy , T Cell Transcription Factor 1/genetics , Prognosis , CD8-Positive T-Lymphocytes , ImmunotherapyABSTRACT
Objective To investigate the effect of Huangkui extract powder (HK) on the expression of nephrin and podocin proteins in mouse podocytes induced by high glucose,which is involved in the treatment of diabetic nephropathy (DN).Methods Cultured mouse podocytes (MPC5) were incubated in high glucose and HK at 5.6 mmol/L NG,5.6 mmol/L NG + 0.45 g/L HK,25 mmol/L HG,25 mmol/L HG + 0.45 g/L HK,respectively.The 5.6 mmol/L NG group was used as normal control.After 24 hours of intervention,we detected podocyte apoptosis by Annexin-V FITC/PI double staining,measured the mRNA and protein expression of nephrin and podocin by qRT-PCR and Western blot.Results Compared with the control group (5.6 mmol/L,NG),the apoptosis rate of podocytes in the high glucose concentration group (25 mmol/L,HG) was significantly higher [(20.39 ± 0.03) ％ vs.(17.70 ± 0.91) ％,t =2.947,P ＜ 0.05)].The apoptosis rate of podocytes in the 25 mmol/L HG + 0.45 g/L HK group was significantly lower than that in the 25 mmol/L HG group [(11.96 ± 1.11) ％ vs.(20.39 ± 0.03) ％,t =7.586,P ＜ 0.01].The results of qRT-PCR and Western blot showed that the expression of nephrin and podocin was significantly inhibited by high glucose concentration compared with the control group[(0.489 ±0.040) vs.(0.721 ±0.022),t =4.992,P ＜0.01;(0.387 ±0.014) vs.(0.778 ±0.036),t =10.050,P ＜0.01],and the expression of podocin and nephrin was increased by appropriate concentration of H K [(0.603 ± 0.013) vs.(0.489 ± 0.040),t =2.653,P＜0.05;(0.640±0.024) vs.(0.387 ±0.014),t=8.946,P＜0.01].Conclusion Podocyte apoptosis can be induced by prolonged high glucose treatment,but a certain concentration of HK can inhibit podocyte death induced by high glucose.The possible mechanism is that HK may inhibit the apoptosis of podocytes by regulating the expression of podocin and nephrin in podocytes at high glucose concentration,thus plays a protective role on podocytes.
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Objective@#To analyze the prevalence of overweight and obesity among adolescents in Wuhan and its association with bullying victimization,and to provide information for relevant interventions.@*Methods@#A total of 3 251 adolescents in senior grade of primary school, middle school and high school were selected by using random clustering sampling method and were surveyed by questionnaire, height and weight were measured.@*Results@#Among the 3 251 students, 523(16.09%) were overweight, and 445 (13.69%) were obesity. In the past 30 days, 732 (22.52%) of the adolescents had ever been bullied and 101(3.11%) had often been bullied. The relationship between overweight/obesity and bullying victimization among boys was not statistically significant by controlling areas and age(P>0.05). While girls who were overweight or obesity were more likely to be bullied (OR=1.78，1.58, P<0.05).@*Conclusion@#Overweight and obesity have a certain influence on the physical and mental development of adolescents, which may increase the possibility of being bullied among girls. Strategies should be taken to prevent overweight and obesity among children and adolescents, and a healthy body shape appreciation should be established, to reduce the incidence of bullying.
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Objective To compare the effects of general anesthesia and spinal anesthesia on prognosis of cesarean section in parturients with medium and severe pulmonary arterial hypertension (PAH).Methods Parturients with medium and severe PAH,at ≥ 24 weeks of gestation,aged 20-45 yr,undergoing elective cesarean section under general or epidural anesthesia from November 1,2011 to December 31,2017 in our hospital,were divided into general anesthesia group and epidural anesthesia group according to the anesthetic method.General anesthesia was combined intravenous-inhalational anesthesia.The highest temperature within 5 days after surgery,the lowest SpO2 (inhaling oxygen 2-4 L/min via a nasal tube) within 3 days after surgery,duration of intensive care unit stay,time of postoperative use of antibiotics,requirement for targeted drugs for pulmonary hypertension,results of laboratory tests (blood biochemistry,coagulation function),postoperative mechanical ventilation,length of hospital stay,and hospitalization costs were recorded.The Apgar score and weight of the newborn,postoperative complications and death of the newborn and parturients in hospital were recorded.Cox regression analysis was used to identify the risk factors after cesarean section in parturients with medium and severe PAH.Results Fifty-seven parturients were enrolled in this study,with 21 cases in general anesthesia group and 36 cases in epidural anesthesia group.Compared with general anesthesia group,the rate of postoperative mechanical ventilation was significantly decreased,the incidence of adverse events of parturients in hospital and mortality rate were decreased,the postoperative level of albumin was increased,activated partial thromboplastin time was shortened (P＜0.05),and no significant change was found in the other parameters in epidural anesthesia group (P＞ 0.05).The results of Cox regression analysis showed that anesthetic method and preoperative SpO2difference were independent risk factors for cesarean section-related adverse events and death of parturients with medium and severe PAH.The risk of adverse events and death of parturients was significantly higher in general anesthesia group than in epidural anesthesia group (P＜0.05).Conclusion Epidural anesthesia produces better prognosis than general anesthesia when used for cesarean section in parturients with moderate and severe PAH.
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To analyze the prognostic factors for patients with or without cardiovascular diseases after craniotomy for aneurysm clipping, and to provide evidences for the improvement of perioperative management in these patients. Methods: We collected 297 patients who underwent craniotomy for aneurysm clipping in Xiangya Hospital of Central South University from May 2016 to February 2017. The patients were divided into two groups: the cardiovascular disease group and the non-cardiovascular disease group. The perioperative clinical data, neurological function assessments at admission and discharge and Glasgow Outcome Scale (GOS) scores of one-year-follow-up after discharge were analyzed. The primary outcome of this study was the GOS scores collected at one year after discharge. The secondary outcomes were the lengths of their ICU stay, neurological functions at discharge and adverse events morbidity during the hospitalization. Results: A total of 241 patients were eventually enrolled. There was no significant difference in their general data between the two groups except for their ages. The GOS scores of the one-year-follow-up were significantly different between the two groups (P=0.007). The lengths of ICU stay, neurological dysfunctions at discharge and adverse events morbidity during hospitalization were also significantly different (P=0.036, P=0.011, P=0.005, respectively). A multivariate logistic regression analysis in which GOS score was the dependent variable with age adjusted also supported the previous results that long-term prognosis was not significantly correlated with the age of patients (P>0.05), but it was correlated with cardiovascular disease and sanity at admission (P=0.001). In patients with cardiovascular diseases, there was significantly different in perioperative mortality and neurological recovery of patients who had or had not cardiovascular events (P=0.006, P=0.001, respectively). Conclusion: Undergoing craniotomy for aneurysm clipping, patients with cardiovascular diseases have worse outcomes in both of short and long terms. Perioperative treatments for cardiovascular disease could not only improve postoperative neurological deficits, but also reduce mortality for these patients.
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Humans , Craniotomy , Intracranial Aneurysm , Postoperative Period , Prognosis , Treatment OutcomeABSTRACT
Objective:To determine the intervention measures for the decrease of cerebral tissue oxygen saturation during anesthesia for the congenital heart disease in children.Methods:Twenty-eight children with cardiac surgery were enrolled.Anesthesia was deepened with propofol (3 mg/kg) intravenous injection.The data of cerebral tissue oxygen saturation(SctO2),mean arterial pressure (MAP),HR,bispectral index (BIS),arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2),hemoglobin (Hb) and middle cerebral artery (MCA) mean flow velocity (Vm) at different points were collected after intravenous injection ofpropofol at 3 mg/kg.The changes of SctO2 and the influential factors were analyzed.Results:SctO2 decreased by 4.99％ after deepen anesthesia,with 95％ CI 4.33％ to 5.65％ (P＞0.05).There was no significant differince in MAP,PaO2,PaCO2,and Hb between the time points after deepen anesthesia and the baseline (P＞0.05).MCA Vm decreased obviously after deepen anesthesia for 1,5,10 min (P＜0.05).The decrease in MAP,HR,PaCO2 and MCAVm is positively correlated with the decrease in SctO2.Conclusion:The decrease of MAP,HR,PaCO2,and MCAVm is the risk factor for SctO2.To avoid the decrease,it needs to maintain the stability of SctO2 and prevent neurological complications.
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Objective To observe the effect of ropivacaine on bilateral posterior thoracic paravertebral nerve block for cardiopulmonary bypass.Methods A total of 142 patients undergoing elective cardiac valve surgery,68 males and 74 females,were randomly divided into two groups:group C (general anesthesia,n =69) and group P (general anesthesia+ paraverteral nerve block with ropivacaine,n=73).The changes of hemodynamics,BIS,anesthesia dose and postoperative anesthesia were observed before and after anesthesia,the time of mechanical ventilation,the duration of vasoactive drug support,ICU stay time,length of stay and hospitalization costs were recorded.Results Compared with group C,heart rate and blood pressure were more stable in group P,and the dosage of sufentanil was less [(130.6±5.0) μg vs (202.8±7.4) μg,P＜0.01],the patient was awakened quickly [(241.0±15.8) min vs (417.6±38.9) min,P＜0.05],and the time of mechanical ventilation [(466.0±22.9) min vs (657.8±49.4) min,P＜0.05] and ICU residence time [(22.1±1.0) h vs (34.1±3.6) h,P＜0.05] were shortened,the cost of hospitalization decreased [(72 360±1 565) yuan vs (78 420±2 094) yuan,(P＜0.05)].Conclusion Thoracic paravertebral nerve block anesthesia combined with general anesthesia is better than pure general anesthesia,in terms of maintaining intraoperative circulation stability,reducing the amount of anesthetic analgesic drugs,and early recovery of patients after surgery.