ObjectiveTo research prognostic prediction value of serum γ-glutamyltransferase-to-prealbumin ratio (GPR) for patients with hepatocellular carcinoma (HCC) after radical resection. MethodsThe clinical data of HCC patients undergoing radical resection from January 2013 to November 2021 were analyzed retrospectively. The optimal critical value of GPR was determined by receiver operating characteristic (ROC) curve. The patients were allocated into the low GPR group (GPR was the optimal critical value or less) and the high GPR group (GPR was greater than the optimal critical value). The differences of clinicopathologic characteristics were compared between the two groups. The overall survival (OS) and relapse-free survival (RFS) were analyzed by the Kaplan-Meier survival curve and compared by the log-rank test between the two groups. The risk factors affecting the OS and RFS of patients with HCC were analyzed by univariate and multivariate Cox regression, and the predictive value of GPR on the OS was evaluated by ROC curve. ResultsA total of 216 eligible HCC patients were gathered. The optimal critical value of GPR was 0.29, 93 cases were in the low GPR group and 123 cases were in the high GPR group. Compared with the low GPR group, the proportions of the patients with preoperative alanine aminotransferase >50 U/L, albumin <40 g/L, total bilirubin ≥34.2 μmol/L, tumor size >5 cm, multiple tumor lesions, stage Ⅲ of China liver cancer staging (CNLC), and major hepatectomy (liver segment resection was 3 or more) were higher in the high GPR group (P<0.05). The Kaplan-Meier survival curve showed that the OS and RFS of the low GPR group were better than those of the high GPR group (χ2=14.356, P＜0.001; χ2=7.963, P=0.005). Cox regression multivariate analysis showed that the preoperative alpha-fetoprotein (AFP) ≥400 μg/L, GPR >0.29, stage Ⅲ of CNLC, and operation time (more than 3 h) were the risk factors for OS and RFS of HCC patients (P<0.05). The area under the ROC curve of GPR alone and it in combination with risk factors (preoperative AFP and CNLC stage, respectively) and in combination with the above three indicators to predict the OS of patients with HCC were 0.636, 0.712, 0.696, and 0.737, respectively. ConclusionFrom the results of this study, GPR is associated with the postoperative survival of patients with HCC after radical resection, and GPR in combination with preoperative AFP and CNLC stage has a certain predictive value for the OS.
ObjectiveTo observe the clinical characteristics of patients with familial vitreous amyloidosis (FVA) and the efficacy of vitrectomy (PPV) and the occurrence of complications. MethodsA retrospective clinical study. From June 2009 to March 2020, 32 eyes of 18 patients from 3 FVA families who were diagnosed and treated by PPV at Department of Ophthalmology of Jiaxing TCM Hospital were included in the study. Among them, there were 12 males with 22 eyes and 6 females with 10 eyes. The average age of onset was 42.28±3.25 years; the average duration of disease was 3.75±3.93 years. All the affected eyes underwent best corrected visual acuity (BCVA) and B-mode ultrasound examination. A logarithmic visual acuity chart was used in the BCVA examination, which was converted to the logarithmic minimum angle of resolution (logMAR) visual acuity when recorded. The average logMAR BCVA of the affected eye was 1.72±0.53; the intraocular pressure was less than 21 mm Hg (1 mm Hg=0.133 kPa). The vitreous body of the affected eye was obviously cloudy. All the affected eyes underwent standard three-channel PPV through the flat part of the ciliary body, and vitreous specimens were collected for pathological examination during the operation. Peripheral venous blood of probands from 3 families was collected, and the whole exome gene sequencing was performed. The follow-up time after surgery was ≥6 months. The patient's clinical characteristics, fundus lesions in PPV, changes in BCVA after surgery, and complications was observed. One-way analysis of variance or t test was performed for measurement data comparison; χ2 test was performed for count data comparison. ResultsThe vitreous body of the affected eye showed gray-white dense and thick flocculent changes, and the posterior capsule attached to the lens showed "foot disc-like" turbidity; later the lens was mainly cystic opacity. Pathological examination of the vitreous body showed positive staining of Congo red; under a polarized light microscope, it showed apple green dots and sheet-like birefringence. The genetic test results showed that there was a c.307G>C (p.Gly103Arg) missense mutation in the TTR gene of the proband in Family 2. Peripheral retinal hemorrhages in 4 eyes (12.5%, 4/32), retinal tears in 5 eyes (15.6%, 5/32), retinal degeneration in 4 eyes (12.5%, 4/32), retinal detachment were found in PPV 3 eyes (9.4%, 3/32). The vitreous body was filled with C3F8 and silicone oil respectively for 2, 1 eye. Six months after the operation, the logMAR BCVA of the affected eye was 0.39±0.32, which was significantly higher than that before the operation, and the difference was statistically significant (t=15.131, P=0.000). After the operation, high intraocular pressure occurred in 2 eyes (6.3%, 2/32), secondary glaucoma in 1 eye (3.1%, 1/32), retinal detachment in 2 eyes (6.3%, 2/32), neovascular glaucoma (NVG) in 2 eyes (6.3%, 2/32), cataract in 10 eyes (31.3%, 10/32). ConclusionThe vitreous body of FVA eyes are gray-white dense, thick and flocculent, attached to the posterior lens capsule, showing "foot disc-like" turbidity; PPV treatment can effectively improve the BCVA of the FVA eyes; secondary glaucoma, secondary retinal detachment, NVG can occur after surgery.
Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
ObjectiveTo explore the effects of transthyretin (TTR) on biological behavior of retinal microvascular epithelial cell (RMVEC). MethodsRMVEC was cultured in medium with 0 μmol/L and 4 μmol/L TTR. The proliferation, migration and healing abilities (0, 24, 48 hours) of RMVEC with different concentrations of TTR were measured by methyl thiazol tetrazolium (MTT) assay, transwell assay and scarification test. ResultsMTT assay shows that RMVEC with the concentrations of 4 μmol/L TTR [absorbance (A) value=0.17±0.02] glows faster than with the concentrations of 0 μmol/L TTR (A value=0.40±0.03), the difference was statistically significant (t=15.47, P=0.000 1). The transwell assay shows RMVEC with the concentration of 4 μmol/L TTR [(140±7) cells] migrants faster than RMVEC with the concentration of 0 μmol/L TTR [(227±14) cells], the difference was statistically significant (t=5.44, P=0.000 6). The scarification test shows that the RMVEC with the concentration of 4 μmol/L TTR [(134.4±45.4) μm] heals faster than the RMVEC with the concentration of 0 μmol/L TTR [(330.0±23.1) μm], the difference was statistically significant (t=8.25, P<0.01). The cells in 48 hours and 4 μmol/L group were healed completely, but not healed in 0 μmol/L group. ConclusionTTR can promote the proliferation, migration and healing abilities of RMVEC.
In recent years, domestic and foreign scholars have carried out extensive research on the prognostic factors of gastric cancer. Among them, non-specific inflammatory markers and nutritional indicators are the most concentrated in gastric cancer. C-reactive protein, as an acute phase protein, has been widely used to diagnose acute and chronic inflammation throughout the body. Prealbumin is a sensitive indicator of nutrition with a shorter half-life, which can quickly reflect the nutritional status of the body. At present, C-reactive protein and prealbumin as sensitive indicators of inflammation and nutrition, have shown certain predictive value in terms of postoperative complications and prognosis of gastric cancer. This article reviews the use of C-reactive protein, prealbumin and their ratios in predicting postoperative complications and prognosis of gastric cancer, aiming to provide a reference for the diagnosis and treatment of patients after gastric cancer.
Objective To measure the concentration of serum transthyretin (TTR) of patients with different stages of diabetic retinopathy (DR). Methods A total of 176 patients with diabetes mellitus were included in this study. There were 104 males and 72 females. The patients aged from 21 to 74 years, with the mean age of (56±11) years. The diabetes duration raged from 1 to 30 years, with the mean diabetes duration of (10±7) years. The HbA1C was 5.2%−14.1%, with the mean HbA1C of (8.6±2.0)%. According to the fundus examination, 58 patients had DR (33.0%), but the other 118 patients not (67.0%). For these DR patients, 10 patients were in stage Ⅰ (5.7%), 26 patients in stage Ⅱ (14.8%), 8 patients in stage Ⅲ (4.5%), and 14 patients in stage Ⅳ (8.0%). The concentration of serum TTR was measured by enzyme-linked immunosorbentassay kit. The differences in the concentration of serum TTR between different DR stages were compared.Bivariate analysis was used to analyze the influencing factors of TTR. Results The concentrations of serum TTR of the patients without DR or with DR of stage Ⅰ to Ⅳ were (224.96±65.47), (383.68±102.99), (247.44±63.21), (228.2±45.89), (189.34±70.12) mg/L, respectively. The difference between different DR stages was statistically significant (F=14.690,P＜0.001).Bivariate analysis showed that the concentration of TTR was correlation to DR (r=0.179,P=0.017). There was no correlation between the concentration of TTR and diabetes duration (r=−0.027,P=0.727), hypertension (r=0.018,P=0.810), hyperlipoidemia (r=0.101,P=0.182), and the use of insulin (r=−0.032,P=0.675). Conclusion The concentration of serum TTR was increased in early DR patients, and gradually decreased with the progression of DR. The concentration of TTR is correlated to DR.
【摘要】 目的 比较不同给养途径在重症急性胰腺炎（SAP）中的临床效果。 方法 选择2008年1月-2009年4月收治的49例SAP患者，随机分为观察组和对照组。观察组25例采用肠内营养，对照组24例采用全胃肠外营养，比较两组的临床效果。 结果 两组的并发症发生率、感染率和病死率差异均无统计学意义（Pgt;0.05）；治疗后两组患者的血清白蛋白水平和前白蛋白水平均升高，以观察组升高更明显，组间差异有统计学意义（Plt;0.05）。 结论 肠内营养应用于SAP患者临床效果满意，值得关注。【Abstract】 Objective To compare the clinical effects of different rations pathway in severe acute pancreatitis. Methods From January 2008 to April 2009, 49 patients of severe acute pancreatitis were selected and randomly divided into two groups, the observation group (25 patiens) adopted by enteral nutrition, the control group (24 patiens) adopted by total parenteral nutrition, the clinical effects of the two groups were compared and analyzed. Results The differences in the incidence of complications, infection rates and case fatality rates were not statistically significant (Pgt;0.05). The serum albumin level and prealbumin level of patients in both groups after treatment were significantly increased. Those in the observation group increased more obviously, and the differences between the two groups were statistically significant (Plt;0.05). Conclusion Enteral nutrition in patients with severe acute pancreatitis has satisfactory clinical effects.
Objective To explore transthyretin (TTR) effect on retinal vascular endothelial cells (hREC) under high glucose and hypoxia environment. Methods hREC and human retinal pigment epithelial cell (hRPEC) were cultured at low-glucose (LG), high glucose (HG) and hypoxia. The glucose concentration was increased from 5.5 mmol/L up to 25 mmol/L, and hypoxia was induced by 200 μmol/L CoCl2. The cells were divided into LG group, LG-hypoxia group, HG group, HG-hypoxia group according to the different cell culture environment. The growth index was detected at 0, 4, 8, 16, 24, 36, 48, 60, 72 hours after cultured. Furthermore, hREC and hRPEC were also cultured with additional TTR (4 μmol/L), respectively. Then transwell co-culture system was employed to reveal the effects of hRPEC on the growth of hREC. Results At 72 hours after cultured, the growth index of hREC and hRPEC in LG group were increased as compared with LG-hypoxia group and HG group (hREC: F=17.098, 22.970; P < 0.05. hRPEC: F=45.442, 9.011; P < 0.05); the growth index of hREC and hRPEC were decreased in HG group and HG-hypoxia group (hREC: F=146.184, P < 0.05；hRPEC: F=27.907, P < 0.05). Additionally, hREC could be significantly repressed by added TTR during culture with high concentration of glucose (F=161.430, 24.106; P < 0.05). hREC could be significantly increased by added TTR during culture with low concentration of glucose (F=200.486, 48.662; P < 0.05). In co-culture process, hRPEC revealed inhibition activity against hREC under both natural and abnormal environment (LG group: F=15.711, P < 0.05; LG-hypoxia group: F=45.659, P < 0.05; HG group: F=7.857, P < 0.05; HG-hypoxia group: F=6.348, P < 0.05). Conclusion Under high glucose and hypoxia environment, the growth of hREC from neovascular could be inhibited by TTR.