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25 April 2019, Volume 18 Issue 2 Previous Issue    Next Issue

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Analysis of risk factors and prognosis of cerebral hemorrhage patients accompanied by cortical superficial siderosis CHEN Jie, HU Jin, YANG Kang, FU Yi 2019, 18 (2):  133-138.  DOI: 10.16150/j.1671-2870.2019.02.003 Abstract ( 575 )   HTML ( 0 )   PDF (604KB) ( 70 )   Objective: To investigate the related factors of cortical superficial siderosis (cSS) in cerebral hemorrhage patients associated with cerebral amylodid angiopathy (CAA) and its prognosis. Methods: A prospective study was performed on patients diagnosed as cerebral hemorrhage by CT within 3 days after onset and MRI was performed within 5 days for detecting cortical superficial siderosis (cSS ), cerebral microbleeds (CMBs) and leukoaraiosis (LA). Patients were followed up 1 year for observation of subsequent clinical cerebrovascular events. Result: Altogether 241 patients with cerebral hemorrhage were enrolled, including 185 cases of deep hemorrhage and 56 cases of lobar hemorrhage. The occurrence of cSS in lobar hemorrhage was more than that in deep hemorrhage (13/56, 23.2% vs 12/185, 6.5%, P<0.001). According to the modified Boston criteria, 42 patients (17.4%) were possible CAA. During the 1-year follow-up, 35 (14.5%) patients had clinical cerebrovascular events or death, and 13(31.0%) possible CAA patients had recurrent cerebral hemorrhage. Kaplan-Meier showed a higher risk of recurrent cerebral hemorrhage in possible CAA accompanied by cSS ( χ2=7.466, P=0.006). The multivariate COX regression model found that cSS was an independent predictor of recurrent cerebral hemorrhage in patients with possible CAA (HR 4.45; 95% CI 1.3714.48, P=0.013). Conclusions: The prevalence of cSS in patients with lobar hemorrhage was higher than that in deep bleeding. Possible CAA accompanied by cSS had an increased risk of recurrent cerebral hemorrhage within one year. Figures and Tables | References | Related Articles | Metrics

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The diagnostic value of smart three-dimensional superb microvascular imaging in detecting blood flow distribution pattern of breast lesion LI Weiwei, ZHAN Weiwei, ZHOU Wei, TAO Lingling, WANG Yi, FAN Jinfang, FEI Yuanxin, KUANG Lijun, XU Wenying 2019, 18 (2):  139-143.  DOI: 10.16150/j.1671-2870.2019.02.004 Abstract ( 404 )   HTML ( 0 )   PDF (615KB) ( 176 )   Objective: To study the characteristics of Smart 3D SMI blood flow distribution in breast mass and evaluate the three-dimensional image characteristics of blood flow distribution pattern in breast cancer. Methods: Smart 3D SMI features of 145 pathologically confirmed breast cancer were analyzed. The characteristics of blood flow distribution pattern of breast cancer was evaluated in coordination with the characteristics of contrast enhanced ultrasound (CEUS) pattern of corresponding area. Results: Of the Smart 3D SMI of 145 breast cancer patients, the spherical blood flow distribution pattern with abundant blood flow was the most frequent (58 cases, 40%), then was the branched pattern (32 cases, 22%), and dot-line pattern was the least (11 cases, 8%).Comparing the blood flow distribution pattern of CEUS and Smart 3D SMI, CEUS showed that all cases had contrast agent perfusion. Of the patients with dot-line pattern of Smart 3D SMI, 55% showed rough and rich blood flow, while in branched pattern, spherical pattern, expansion pattern and mixed pattern, 75%, 72%, 75% and 52% showed rough and rich blood flow, respectively. Of the various Smart 3D SMI pattern, CEUS showed that in 82%, 75%, 67%, 60% and 58% of dot-line pattern, branched pattern, spherical pattern, expansion pattern and mixed pattern, respectively, the branched blood flow could not been clearly delineated. The perfusion intensity of branched and spherical pattern was higher than that of dot-line pattern, and the difference was significant(P=0.018, 0.006). The perfusion area was mostly located in interior of the mass in dot-line pattern, branched pattern and spherical pattern, and only a few cases had radial perfusion at periphery of the mass. Conclusions: Smart 3D SMI technology is commonly used in the evaluation of ultrasound micro-blood flow distribution of breast mass, spherical pattern and branched pattern are the frequently seen pattern. The three-dimensional morphological characteristics can afford more information regarding the blood flow distribution pattern of breast cancer. Figures and Tables | References | Related Articles | Metrics

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Establishment of a detection method for tumor suppressor gene HIC-1 methylation in cell-free DNA and its significance in diagnosis of breast diseases ZHONG Ming, ZHAO Feng, WU Yan, PEI Wenjiang, GAO Hang, GUO Shanyu, DAI Qiancheng, ZHANG Wei 2019, 18 (2):  144-148.  DOI: 10.16150/j.1671-2870.2019.02.005 Abstract ( 274 )   HTML ( 0 )   PDF (817KB) ( 75 )   Objective: To establish a detection method for gene hypermethylated in cancer 1（HIC-1） methylation in cell-free DNA in peripheral blood and to evaluate its significance in diagnosis of benign and malignant breast tumors. Methods: The cell free DNA was extracted from 45 blood samples including breast disease patients and healthy volunteers. These DNA were treated with bisulfite and using Bisulfite Sequencing PCR(BSP) method to detect the methylation level of the 16 CpG sites in HIC-1 gene promoter region -636—-424 bp. Results: Of the breast cancer group, the methylation trend was obvious among the 4 sites in -636—-617 bp. Its average methylation rate was 22.6%. Frequency of methylation of HIC-1 gene promoter region was significantly higher in 25 patients with breast cancer compared with that in 10 benign tumor samples (22.6% vs 8.5%, P<0.05) and 10 healthy control samples (22.6% vs 8.3%, P<0.05). The ROC curve analysis showed that the area under curve（AUC） was 0.794, indicating a certain diagnostic value for breast cancer. Conclusions: The detection of HIC-1 gene promoter methylation in cell-free DNA has certain clinical significance in the diagnosis of breast cancer. Figures and Tables | References | Related Articles | Metrics

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Interobserver variability in sonographic evaluation of thyroid nodules with ACR-TIRADS and RJ-TIRADS XU Shangyan, JIA Xiaohong, NI Xiaofeng, ZHAN Weiwei 2019, 18 (2):  149-154.  DOI: 10.16150/j.1671-2870.2019.02.006 Abstract ( 728 )   HTML ( 0 )   PDF (634KB) ( 78 )   Objective: To evaluate the interobserver variability with the ACR TIRADS（American Radiological Society-Thyroid Imaging Reporting and Data System）and RJ-TIRADS (Ruijin-Thyroid Imaging Reporting and Data System）descriptive category terms of sonographic (US) features ofthyroid nodules. Methods: Retrospective analysis was conducted on 597 nodules. The US findings of each thyroid nodule were analyzed by two radiologists having at least 5 years of experience. All these cases had been pathologically confirmed. Interobserver variability was calculated using Cohen's Kappa statistics. Results: All the descriptive terms had statistical significance. In ACR-TIRADS, there were fair agreement for margin, moderate agreement forecho and calcification; internal structure showed substantial agreement.In RJ-TIRADS, there were no descriptive terms with weak agreement. Moderate agreement was found for echo level and internal blood flow, while substantial agreement was found with regard to margin, boundary, internal structure and calcification. With regard to category, for ACR-TIRADS, TIRADS 1, 2, 3 and 5 showed substantial agreement, while TIRADS 4 showed moderate agreement; for RJ-TIRADS, TI-RADS3, 4C and 5 showed substantial agreement, while TIRADS 4A and 4B showed moderate agreement. If the TIRADS 4 category was evaluated as a whole, the agreement between observerswas better. Conclusions: Both versions of TIRADS have good clinical value in evaluating thyroid nodules. In ACR-TIRADS, the agreement for margin is somewhat weaker, and should be evaluated as a whole or evaluated carefully when used. Both versions of TIRADS require further study to improve the agreement between observers, and classes 4A and 4B in RJ-TIRADS could be combined for elevating the agreement. Figures and Tables | References | Related Articles | Metrics

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Value of anti-melanoma differentiation-related gene 5 antibody for assessing disease activity and prognosis in patients with dermatomyositis-associated interstitial lung disease WANG Juan, WANG Kaiwen, ZHAO Jiangfeng 2019, 18 (2):  155-159.  DOI: 10.16150/j.1671-2870.2019.02.007 Abstract ( 683 )   HTML ( 2 )   PDF (558KB) ( 124 )   Objective: To study the expression level of anti-melanoma differentiation gene 5 antibody (anti-MDA5 antibody) in serum of idiopathic inflammatory myopathy (IIM) patients associated with interstitial lung disease (ILD), and to explore the relationship between anti-MDA5 antibody and clinical characteristics, severity and 6-month mortality of IIM-ILD patients for providing laboratory evidences to delineate new immune intervention pathway. Methods: The expression of anti-MDA5 antibody in serum of 104 patients with IIM or IIM-ILD, including polymyositis 4 cases, dermatomyositis 8 cases, amyopathic dermatomyositis, 7 cases, polymyositis-ILD 17 cases, dermatomyositis-ILD 25 cases, amyopathic dermatomyositis-ILD 43cases, and normal control group was detected by ELISA, and the relationships between anti-MDA5 antibody and lung function [FVC% and DLCO/SB (single breath, carbon monoxide diffusing capacity)], lung structure [HRCT score (high resolution CT score)] and 6-month survival were analyzed. Results: In patients with amyopathic dermatomyositis (ADM), the serum level of anti-MDA5 antibody was higher than that of normal controls, patients with dermatomyositis (DM), IIM not associated with ILD and polymyositis (PM) with ILD(P<0.005). Compared with DM-ILD patients, the serum level of anti-MDA5 antibody in patients with ADM-ILD was increased (P<0.05). There was no correlation between anti-MDA5 antibody level and lung function in patients with IIM (FVC% r=-0.04425 P=0.7579, DLCO/SB, r=-0.06839 P=0.6335), and was positively correlated with lung structural changes (r=0.3879 P=0.0002). The 6-month mortality of IIM patients with positive anti-MDA5 antibody was significantly different from that of anti-MDA5 antibody negative patients (P=0.0002). Conclusions: The anti-MDA5 antibody level detected by ELISA is closely correlated with lung function, severity of lung structural damage and mortality in patients with DM-ILD, especially ADM-ILD. Figures and Tables | References | Related Articles | Metrics

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Pleomorphic giant cell adenocarcinoma of prostate: clinicopathological analysis of a case and review of literature HE Yanyan, FENG Lijin, WEI Qing 2019, 18 (2):  160-164.  DOI: 10.16150/j.1671-2870.2019.02.008 Abstract ( 244 )   HTML ( 0 )   PDF (1000KB) ( 95 )   Objective: To study the clinicopathological features, diagnosis, differential diagnosis and prognosis of pleomorphic giant cell adenocarcinoma (PGCA) of prostate. Methods: Clinicopathological and follow-up data of one case of PGCA of prostate were collected and analyzed retrospectively, including immunophenotype. Results: In this case, in addition to the component of conventional high-grade prostate acinar adenocarcinoma, there was also a 5% of PGCA in the prostate tissue. The cells in this area were bizarre, giant, pleomorphic with multinucleate and atypical mitotic figures. Immunohistochemistry showed that the PGCA tumor cells expressed P504S, AE1/AE3, CAM5.2, and partially expressed PSA (60%) but not PSMA, ETS related gene or AR. The response of routine androgen blocking therapy before surgery was poor, and the clinical stage was PT4N0M0, which was highly invasive. Conclusions: PGCA of prostate is a newly defined and extremely rare tumor characterized by pleomorphism. The immunohistochemical expression shows different degrees of loss of prostate-specific antigen, suggesting great heterogeneity of the tumor and poor effect of endocrine therapy, which is different from that of conventional prostate adenocarcinoma. The diagnosis and differential diagnosis is difficult. The clinical course is typically highly aggressive. Therefore, to identify this particular subtype is crucial for clinical follow-up treatment and prognosis. Figures and Tables | References | Related Articles | Metrics

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Report of a case of composite pheochromocytoma and review of literature JIN Jiaoying, LI Qianyu, JIANG Hongwei, HAN Dongyan, XI Hao, WEI Qing 2019, 18 (2):  165-169.  DOI: 10.16150/j.1671-2870.2019.02.009 Abstract ( 428 )   HTML ( 0 )   PDF (925KB) ( 103 )   Objective: To study the clinicopathological characteristics and immunotype of composite pheochromocytoma-ganglioneuroma (CP-GN). Methods: The clinicopathological features of one CP-GN patient were analyzed by HE and immunochemistry staining，and related literatures were reviewed. Result: The patient was a male with adrenal mass. Pathological examination revealed that the tumor consisted of two components: the first component was pheochromocytoma,tumor cells were arranged in nests with basophilic or amphiphilic cytoplasm; the other component was ganglioneuroma, the ganglion cells were scattered in the background of the bundle and braided schwann cells. Both CgA and Syn were strongly and diffusely positive in the pheochromocytoma, while staining for S100 protein and NF identified Schwann cells and ganglion cells were observed in the ganglioneuroma. The Ki-67 index was low in CP-GN. Conclusions: CP-GN is rare, and its histological structure is mixed. Patient has better prognosis after operation. Figures and Tables | References | Related Articles | Metrics

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Study on ANP32B expression in hepatocellular carcinoma and its significance ZHU Di, ZHU Xiaona, YANG Shuo, HE Ping, SHEN Shaoming, YU Yun 2019, 18 (2):  170-176.  DOI: 10.16150/j.1671-2870.2019.02.010 Abstract ( 206 )   HTML ( 4 )   PDF (981KB) ( 41 )   Objective: To investigate the ANP32B (acidic leucine-rich nuclear phosphoprotein 32B）expression in hepatocellular carcinoma and determine its clinical significance. Methods: The mRNA expression of ANP32B in hepatocellular carcinoma and the overall survival were analyzed using international public datasets. The protein expression of ANP32B in hepatocellular carcinoma tissue was detected by immunoblotting. ANP32B was knockdown by shRNA in HCC cell lines, and cell growth and colony formation were analyzed; cell cycle and apoptosis were detected by flow cytometry. Results: ANP32B mRNA and protein level were highly expressed in hepatocellular carcinoma, and the higher ANP32B mRNA level was associated with shorter survival. Knockdown of ANP32B in HCC cell lines inhibited cell growth and colony formation, induced cell cycle arrest and cell apoptosis. Conclusions: ANP32B is highly expressed in hepatocellular carcinoma. Knockdown of ANP32B in HCC cell lines inhibited cell growth and colony formation, induced cell cycle arrest and cell apoptosis. Figures and Tables | References | Related Articles | Metrics

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The correlation between different fat distribution indices and dyslipidemia in middle-aged population in Shanghai WANG Shanshan, ZHOU Yingxia, HU Lijuan, NIU Jingya, WANG Tiange, LI Mian, ZHAO Zhiyun, XU Yu, LU Jieli, XU Min, BI Yufang, NI Hengru 2019, 18 (2):  177-182.  DOI: 10.16150/j.1671-2870.2019.02.011 Abstract ( 301 )   HTML ( 0 )   PDF (596KB) ( 69 )   Objective: To investigate the correlation between different fat distribution indices and dyslipidemia in community residents of Songnan District in Shanghai. Methods: A survey was conducted among 550 community residents in Songnan District, Shanghai. Questionnaires was used to collect information on health status, medical history, and lifestyle. Subjects received physical examinations for height, body weight, waist circumference, and blood pressure measurement. Venous blood sample was collected after an overnight fast and blood lipids and glucose were tested. CT and FATSCAN software were used to measure abdominal visceral fat area and subcutaneous fat area. Results: The proportion of dyslipidemia among 550 community residents in Songnan District was 65.1%. Measures of fat distribution indices such as body-mass index (BMI), waist-hip ratio, waist circumference, visceral fat area, subcutaneous fat area in individuals with dyslipidemia were significantly higher than individuals with normal blood lipids (P<0.05). Multivariable logistic regression analysis showed that after adjustment for sex, age, current smoking, current drinking, educational attainment, systolic pressure, HbA1c, blood glucose-lowering treatment and insulin resistance, one-SD increase in waist-hip ratio was associa-ted with 87% increase in risks of having high LDL-cholesterol; one-SD increase in waist circumference was associated with 60% increase in risks of having low HDL-cholesterol and 45% increase in risks of having dyslipidemia. Conclusions: Most indicators of fat distribution such as BMI, waist-hip ratio, waist circumference, visceral fat area, and subcutaneous fat area are correlated with dyslipidemia, however, the degree of correlation is different. Waist-hip ratio might be more important in the association with high LDL-cholesterol. Waist circumference might be more important in the association with low HDL-cholesterol and dyslipidemia. Figures and Tables | References | Related Articles | Metrics

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Lung cancer screening by low-dose CT in asymptomatic population undergoing physical examination: preliminary analysis of 22 351 cases in Shanghai ZHAO Junsong, CUI Li, HE Jiangbo, ZHU Xiaoyun, LIU Lihong, HUANG Wei, XU Xueqin, CHEN Kemin 2019, 18 (2):  183-188.  DOI: 10.16150/j.1671-2870.2019.02.012 Abstract ( 660 )   HTML ( 2 )   PDF (668KB) ( 122 )   Objective: To analyze the results of low-dose CT(LDCT) screening for lung cancer in asymptomatic patients. Methods: From April 2015 to April 2018, 22 351 asymptomatic patients(16—95 years old) underwent lung LDCT examination. According to the size and type of nodules, they were divided into positive nodules, semi-positive nodules and negative nodules. The results of LDCT lung nodule detection and lung cancer screening in different age groups and gender groups were analyzed. Detection of different types of nodule in positive and semi-positive nodules was analyzed too. The changes of nodule during follow-up were recorded. Results: The total detection rate of pulmonary nodule was 31%. The detection rates in male and female were 34.1% and 28.8%, respectively; the difference was significant ( χ2=70.47, P<0.001). The detection rate of nodule was different in different age groups, and the difference was statistically significant ( χ2=1 032.96, P<0.001). The older the age group, the higher the detection rate of nodule. The detection rate of nodule in 81—95 age group was the highest (50.0%). The detection rate of positive nodules was different in different genders, the difference was statistically significant ( χ2=184.36, P<0.001). The detection rate of positive nodules in male population (10.1%) was higher than that in female group (8.6%). The detection rate of positive nodules was different in different age groups, and the difference was statistically significant ( χ2= 434.89, P<0.001). The overall detection rate of lung cancer was 0.4%. Forty-eight cases of lung cancer were detected by baseline screening, and 47 cases of lung cancer were detected by follow-up within 36 months. There was a significant difference in detection rate of lung cancer between different genders ( χ2=7.52, P=0.006). The detection rate of lung cancer in male and female was about 0.6% and 0.3%, respectively. The detection rate of lung cancer in patients over 50 years old was significantly higher than those under 50 years old, and the detection rate was about 0.7% and 0.1%, respectively. The difference was statistically significant ( χ2=42.20, P=0.006). P<0.001). The detection rates of lung cancer in positive and semi-positive nodule groups were 4.5% and 0.1%, respectively. The difference was statistically significant ( χ2=207.78, P<0.001). The proportion of positive and semi-positive nodule in nodules of different density types was different ( χ2=267.06, P<0.001). The detection rate of malignant nodule in different density types was different, the difference was statistically significant ( χ2=131.77, P<0.001). The detection rate of malignant nodule in part-solid nodules was high, up to 4.3%. During the follow-up period, 4 557 patients with semi-positive nodules underwent annual review or biennial review, and only 2 patients were pathologically confirmed as early lung cancer. Malignant nodules accounted for 0.7% of the detected nodules.Conclusions: LDCT lung cancer screening is very important for middle-aged and elderly people, especially those over 50 years old. For semi-positive nodules, annual review is feasible. For the screened pulmonary nodules, the overall proportion of malignant nodules (0.7%) is low. A reasonable follow-up management plan should be formulated according to the size, type and morphological characteristics of nodules. Figures and Tables | References | Related Articles | Metrics

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Influencing factors of axillary lymph node metastasis in patients with locally advanced breast cancer WANG Zhiwei, ZHANG Xiaoxiao, WANG Jie, WEI Min, SHAO Yuguo, JI Min, YANG Li, HE Qi 2019, 18 (2):  189-192.  DOI: 10.16150/j.1671-2870.2019.02.013 Abstract ( 395 )   HTML ( 0 )   PDF (499KB) ( 121 )   Objective: To investigate the influencing factors of axillary lymph node metastasis in patients with locally advanced breast cancer. Methods: The clinical pathological data of 233 locally advanced breast cancer patients with at least 4 axillary lymph nodes metastasis from April, 2008 to April, 2018 in our hospital were collected retrospectively. The age, molecular type (luminal A/luminal B, HER-2 positive/negative, triple negative), tumor diameter, histological grade and the expression of ER/PR, HER-2, Ki-67 were compared between patients with N2 and N3 axillary lymph node metastasis. Results: Of the 233 locally advanced breast cancer patients, 141 patients were in Group N2 while 92 patients were in Group N3. The proportions of T1, T2, T3 and T4 in N2 group were 46.1%, 49.6%, 2.8% and 1.4%, respectively, whereas that in N3 group were 27.2%, 58.7%, 13.0% and 1.1%, respectively. The diameter of tumor was larger in N3 group than in N2 group(P=0.002）. There was no statistical difference between Group N2 and N3 in terms of age, molecular type, histological grade, ER/PR expression, HER-2 expression and Ki-67 expression (P>0.05). Conclusions: In locally advanced breast cancer, the number of axillary lymph nodes metastasis is correlated significantly with the diameter of tumor (T stage). while no correlations with age, molecular type, histological grade, ER/PR expression, HER-2 expression and Ki-67 expression are found. Figures and Tables | References | Related Articles | Metrics

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Association between 24-h ambulatory blood pressure variability and cardiac structure and function XU Tingyan, YANG Yan, LI Jingjing, ZHANG Dongyan, WANG Ying, WANG Jiguang, LI Yan 2019, 18 (2):  193-198.  DOI: 10.16150/j.1671-2870.2019.02.014 Abstract ( 450 )   HTML ( 0 )   PDF (605KB) ( 1964 )   Objective: To investigate the association between 24-h ambulatory blood pressure variability and cardiac structure and function in untreated patients. Methods: The association between 24-hour ambulatory blood pressure (BP) recordings and echocardiography in 80 untreated patients referred to a hypertension clinic was assessed. BP variability indices were standard deviation (SD), coefficient of variation (CV), variability independent of the mean (VIM), maximum-minimum difference (MMD), and average real variability (ARV). Effect sizes (standardized β)and partial coefficient of determination were computed using multivariable regression models. Results: Left ventricular mass index(LVMI) (systolic BP: β=6.8—8.0, P<0.01; diastolic BP: β=6.7—7.8, P<0.01), longitudinal strain(LS) (systolic BP: β=-0.76—-0.71, P<0.05; diastolic BP: β=-0.81—-0.71, P<0.05) and septal E/e' (systolic BP: β=0.44—0.57, P<0.05) were associated independently with BP, whereas the association with BP variability was not significant except for those of LVMI with systolic BP CV and VIM ( β=3.3, P=0.048, β=3.4, P=0.049), and of septal E/e' with diastolic BP MMD ( β=0.46, P=0.034). Conclusion: Short-term 24-h blood pressure variability is associated with cardiac structure and function, but blood pressure might be a major factor affecting these cardiac indices. Figures and Tables | References | Related Articles | Metrics

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Correlation between imbalance of T lymphocyte subsets and symptom fluctuation in patients with myasthenia gravis LAI Xiaoyin, SUN Jialan, HU Rongguo, YANG Xuelian, WU Guolu, LI Longxuan, BU Bitao 2019, 18 (2):  199-203.  DOI: 10.16150/j.1671-2870.2019.02.015 Abstract ( 280 )   HTML ( 3 )   PDF (666KB) ( 127 )   Objective: To investigate the relationship between changes of T lymphocytes and exacerbation and remission in patients with generalized myasthenia gravis (GMG). Methods: Flow cytometry was used to detect the change of T lymphocyte subsets in peripheral blood of 51 patients with GMG during different periods of exacerbation and remission, and analyzed the relationship between the changes of T lymphocytes and symptom fluctuations. Results: The percentage of CD4+CD25+CD127low/-regulatory T lymphocytes and CD4+CD45RA+naive T lymphocytes was significantly lower in exacerbation period than that in control group (P<0.05), whereas the percentage of CD4+CD45RO+ memory T lymphocytes in exacerbation period was significantly higher than that in remission period and control group(P<0.05). The AUC of CD4+CD25+CD127low/-regulatory T lymphocytes and CD4+CD45RA+naive T lymphocytes were 0.713 and 0.900, respectively. The AUC of CD4+CD45RO+ memory T lymphocytes in exacerbation period was 0.675 and the optimum critical value was 32.06%. Conclusions: Regulatory T lymphocytes and CD4+CD45RA+naive T lymphocytes have diagnostic value for GMG. CD4+CD45RO+ memory T lymphocytes are correlated with symptom aggravation and remission of GMG, and may be used as a marker for measuring the symptom fluctuation of myasthenia gravis. Figures and Tables | References | Related Articles | Metrics

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Angiotensin-converting enzyme gene insertion/deletion polymorphism and decline of renal function in elderly WU Lin, ZHENG Ge, TAO Ting 2019, 18 (2):  204-208.  DOI: 10.16150/j.1671-2870.2019.02.016 Abstract ( 278 )   HTML ( 0 )   PDF (555KB) ( 64 )   Objective: ACE is the key enzyme of renin-angiotension-aldosterone system(RAAS). The insertion (I allele) deletion (D allele) polymorphism of ACE gene determines the serum level of ACE. There are three genotypes including DD, ID and II. The aim of this study was to study the possible impact of this polymorphism on risk of renal function decline in Chinese elderly people. Methods: A total of 366 elderly patients from geriatrics department of Ruijin Hospital in 2010 was enrolled. Medical history (hypertension and diabetes) was collected, weight and the basic clinical characteristics were measured. Polymerase chain reaction (PCR) was used to determine the ACE genotypes (ID, II, DD). Patients were followed up in 2011 and 2016. After excluding the dead and those lost to follow-up, 152 cases were remained for analysis. These patients were divided into two groups according to the ACE genotypes, the group DD+ID and the group II. Results: Retrospective analysis showed that the 6 years follow-up demonstrated a trend of decline of weight and creatinine clearance rate(Ccr)(P<0.05) and a trend of rising of fast blood glucose level(P<0.05). There were no significant differences in fast blood lipid level, the incidence of diabetes and hypertension(P>0.05). There were no significant differences between group DD+ID and group II for weight, sex, age, fast blood glucose level, fast blood lipid level, incidence of diabetes and hypertension (P>0.05). Group DD+ID had more decline of Ccr than group II(P<0.05). Conclusions: The D allele of ACE gene is a risk factor of decline of kidney function in Chinese elderly people. Figures and Tables | References | Related Articles | Metrics

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Value of single and combined detection of serum pro-gastrin-releasing peptide, alpha fetoprotein and carbohydrate antigen 199 in diagnosis of ovarian cancer JIANG Dongkui, CHEN Zhaoya, MA Dongmei, XU Lin, RAO Qun 2019, 18 (2):  209-214.  DOI: 10.16150/j.1671-2870.2019.02.017 Abstract ( 320 )   HTML ( 0 )   PDF (668KB) ( 65 )   Objective: To investigate the value of single detection of serum pro-gastrin-releasing peptide (ProGRP), α-fetoprotein (AFP), carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4) and combined detection of ProGRP, AFP and CA199 for the diagnosis of ovarian cancer. Methods: Three hundred and seventy nine suspected ovarian cancer patients, including 123 pathologically confirmed cases, admitted from January 2014 to February 2017 and another 256 patients with non-ovarian cancer served as control group were analyzed retrospectively. Serum levels of ProGRP, AFP, CA199, CA125, HE4 in the two groups were compared, and the diagnostic efficacy of single detection of ProGRP, AFP, CA199, CA125, HE4 and combined detection of ProGRP, AFP, CA199 for ovarian cancer was analyzed. ROC curves were plotted based on ProGRP, AFP, CA199, CA125, HE4, and ProGRP, AFP, CA199 combined detection. The AUC under the ROC curve were calculated. Results: The levels of serum ProGRP, AFP and CA199 in patients with stage Ⅰ and Ⅱ of the ovarian cancer were significantly lower than those in stage Ⅲ and Ⅳ(P<0.05). The levels of serum ProGRP, AFP, CA199, CA125 and HE4 of ovarian cancer group were significantly higher than those of the non-ovarian cancer group (P<0.05). The optimal cutoff values of serum ProGRP, AFP, CA199, CA125 and HE4 for diagnosis of ovarian cancer were 69.21 pg/mL, 28.95 ng/mL, 42.38 U/mL, 57.65 U/mL and 125.64 pmol/L, respectively, and the sensitivity of serum ProGRP, AFP, CA199, CA125, HE4 single detection and the combined detection of ProGRP, AFP and CA199 were 78.05%, 80.49%, 85.37%, 88.62%, 91.06% and 77.24%, respectively, the specificity were 85.94%, 86.72%, 87.89%, 90.63%, 90.23% and 97.27%, respectively, the detection accuracy were 83.37%, 84.70%, 87.07%, 89.97%, 90.50% and 90.77%, respectively. The AUC of serum ProGRP, AFP, CA199, CA125, HE4 and combined detection of ProGRP, AFP and CA199 were 0.786, 0.821, 0.897, 0.912, 0.926 and 0.948, respectively. Conclusions: Serum ProGRP, AFP, CA199, CA125, HE4 detection and combined detection of ProGRP, AFP and CA199 all have good performance in the diagnosis of ovarian cancer, and the reliability of combined detection of ProGRP, AFP and CA199 is better, which could be used for screening of ovarian cancer. Figures and Tables | References | Related Articles | Metrics