术前血小板与淋巴细胞比值在上尿路尿路上皮癌患者中预后价值的Meta分析

目的:系统评价根治性肾输尿管切除术前血小板与淋巴细胞比值(PLR)在上尿路尿路上皮癌(upper tract urothelial carcinoma,UTUC)患者中的预后作用。方法:本研究已经在PROSPERO平台预先登记注册(编号:CRD42020186645)。两名研究员独立全面检索Pub Med、WebofScience、EMBASE、Cochrane Library、中国生物医学文献数据库、CNKI和万方数据库中,关于研究根治性肾输尿管切除术(radical nephroureterectomy,RNU)前PLR在UTUC患者中预后价值的文献。检索时间截止至2021年5月。依据纳入和排除标准进行文献筛选、资料提取和质量评估。应用Stata 12.0和Rev Man 5.3软件对相关数据进行荟萃分析。结果:最终纳入来自10篇回顾性研究,共3287例接受RNU治疗的UTUC患者。Meta分析结果显示,升高的术前PLR与UTUC患者术后较差的总体生存率[HR=1.51,95%CI(1.17~1.94),P=0.001]、癌症特异性生存率[HR=1.52,95%CI(1.21~1.90),P<0.001]、无疾病生存率[HR=1.32,95%CI(1.12~1.56),P=0.001]和无进展生存率[HR=1.88,95%CI(1.41~2.52),P<0.001]有关。敏感性分析进一步验证了本研究结果的稳定性与可靠性。结论:作为一项简单且临床易于获取的指标,术前外周血PLR能够有效提高当前预后模型的准确性,并有助于为UTUC患者制定个性化的临床诊疗策略。

Prognostic value of platelet-to-lymphocyte ratio in upper tract urothelial carcinoma patients treated with radical nephroureterectomy:A metaanalysis

Objective:To evaluate the prognostic value of platelet-to-lymphocyte ratio(PLR)in upper tract urothelial carcinoma(UTUC)patients treated with radical nephroureterectomy.Methods:This study was pre-registered in PROSPERO(No.CRD42020186645).Two reviewers independently performed a comprehensive literature search on PubMed,Web of Science,EMBASE,Cochrane Library databases,China Biology Medicine disc(CBM),Wanfang database,and China National Knowledge Infrastructure(CNKI)from inception to May 2021 for prospective or retrospective cohort studies evaluating the prognostic value of PLR.Literature was analyzed with inclusion and exclusion criteria.Data and other useful clinicopathological features were extracted and analyzed with fixed or random-effect models when applicable.Heterogeneity was assessed on the basis of Cochran’s Q test and I2 statistic.Publication bias was assessed with funnel plots and precisely assessed by Egger's tests.Results:A total of ten studies involving 3287 UTUC patients were included.Meta-analysis showed that elevated preoperative PLR was associated with worse overall survival(HR=1.51,95%CI 1.17-1.94,P=0.001),cancer specific survival(HR=1.52,95%CI 1.21-1.90,P<0.001),disease free survival(HR=1.32,95%CI 1.12-1.56,P=0.001),and progression free survival(HR=1.88,95%CI 1.41-2.52,P<0.001).Furthermore,the sensitivity analyses validated the stability and reliability of the results.Conclusion:The present meta-analysis demonstrates a significant association between elevated preoperative PLR and poor prognosis of UTUC patients treated with radical nephroureterectomy.Hence,PLR could be helpful as a potential prognostic biomarker to guide clinical decision-making and select individualized treatment strategies for UTUC patients.However,more prospective and large-scale trials are needed to provide more evidence.

香芹酚对大鼠心肌缺血/再灌注损伤的保护作用及相关机制

目的探讨香芹酚(CAR)对大鼠心肌缺血/再灌注损伤(I/R)的保护作用及相关分子机制。方法结扎大鼠左冠状动脉前降支制作心肌缺血(30 min)/再灌注(120 min)模型,将大鼠随机分为5组:对照组(A组),模型组(B组),香芹酚10 mg/kg组(C组),香芹酚25 mg/kg组(D组),香芹酚50 mg/kg组(E组)。A组大鼠麻醉后行开胸术,分离左前降支但不结扎,B组于心肌缺血前30 min通过股静脉注入0.5 ml生理盐水,后行缺血/再灌注术,C、D、E组于缺血前30 min分别通过股静脉注入10 mg/kg、25 mg/kg和50 mg/kg香芹酚溶剂,后行缺血/再灌注术。造模后检测心肌梗死面积、ELISA法检测心肌组织氧化应激因子丙二醛(MDA)、过氧化氢酶(CAT)、过氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH),Western blot法检测心肌细胞凋亡蛋白Bax及Bcl-2表达。结果造模后B组梗死面积明显大于A组(P<0.05),而香芹酚预处理后,梗死面积逐渐减小,并呈剂量依赖性(P<0.05);ELISA显示,造模后B组MDA含量明显提高(P<0.05),CAT、SOD和GSH活性明显降低(P<0.05),而香芹酚预处理后,MDA含量明显降低,CAT、SOD和GSH活性明显提高,并呈剂量依赖性(P<0.05);Western blot显示,造模后B组Bax蛋白表达显著提高(P<0.05),Bcl-2显著降低(P<0.05),而香芹酚预处理后,Bax蛋白表达显著降低(P<0.05),Bcl-2显著提高(P<0.05)。结论香芹酚能通过抑制氧化应激反应及心肌细胞凋亡保护大鼠心肌缺血/再灌注损伤。

良性前列腺增生药物治疗的昨天、今天、明天

药物治疗是针对轻中度良性前列腺增生(BPH)的主要治疗手段。本文系统回顾BPH药物治疗的发展历程,对近年来BPH药物治疗的最新理念与进展进行了梳理总结,并对BPH药物治疗未来的发展方向及前景进行展望。

一种链条驱动橡胶传送带卸货的特殊结构半挂车技术研究

近年来,随着我国超限超载治理工作的持续深入,自卸半挂车因载重优势将逐步替代8×4自卸汽车,然而后倾举升式自卸半挂车在使用过程中经常出现翻车事故使得其适用条件大大受限。本文在结合国内外研究的基础上,提出了一种新结构型式——传送带平移卸货特殊结构半挂车,作业安全性技术指标已超越传统举升式自卸半挂车,且通用性与传统举升式自卸车接近,更加高效。