血清uMtCK、PG、G-17及CA72-4联合检测在胃癌辅助诊断中的价值

目的探讨血清广泛型线粒体肌酸激酶(uMtCK)、胃蛋白酶原(PG)、胃泌素-17(G-17)、糖类抗原72-4(CA72-4)联合检测在胃癌辅助诊断中的应用价值。方法选取2018年3月—2019年10月在青岛市中心医院住院治疗的90例胃癌患者作为研究组,另选该院同期90例胃部良性病变患者作为对照组。采用酶联免疫吸附试验检测血清uMtCK水平;采用化学发光法检测PGⅠ、PGⅡ及G-17水平;采用电化学发光法检测CA72-4水平,探讨单独检测和联合检测的诊断价值。结果研究组血清uMtCK、PGⅡ、G-17及CA72-4水平高于对照组(P<0.05),而PGⅠ、PGⅠ/PGⅡ(PGR)水平低于对照组(P<0.05)。研究组血清uMtCK、PGⅠ、PGⅡ、PGR、G-17及CA72-4的阳性率高于对照组(P<0.05),其联合检测的阳性率也高于对照组(P<0.05)。研究组血清uMtCK、PGⅡ、G-17及CA72-4联合检测的敏感性为88.89%(95% CI:0.801,0.942),准确性为86.11%(95% CI:0.802,0.905),均高于各单项指标检测(P<0.05)。AUC结果显示uMtCK、PGⅡ、G-17和CA72-4联合检测诊断价值最大(AUC=0.976),PGⅠ诊断价值最小(AUC=0.810)(P<0.05)。结论 血清uMtCK、PGⅠ、PGⅡ、PGR、G-17及CA72-4联合检测对胃癌具有较好的诊断价值。

GCH1 plays a role in the high-altitude adaptation of Tibetans

Tibetans are welt adapted to high-altitude hypoxia. Previous genome-wide scans have reported many candidate genes for this adaptation, but only a few have been studied. Here we report on a hypoxia gene （GCH1, GTP-cyclohydrolase I）, involved in maintaining nitric oxide synthetase （NOS） function and normal blood pressure, that harbors many potentially adaptive variants in Tibetans. We resequenced an 80.8 kb fragment covering the entire gene region of GCH1 in 50 unrelated Tibetans Combined with previously published data, we demonstrated many GCHI variants showing deep divergence between highlander Tibetans and lowlander Han Chinese. Neutrality tests confirmed a signal of positive Darwinian selection on GCH1 in Tibetans. Moreover, association analysis indicated that the Tibetan version of GCH1 was significantly associated with multiple physiological traits in Tibetans, including blood nitric oxide concentration, blood oxygen saturation and hemoglobin concentration. Taken together, we propose that GCH1 plays a role in the genetic adaptation of Tibetans to high altitude hypoxia.

EP300 contributes to high-altitude adaptation in Tibetans by regulating nitric oxide production

The genetic adaptation of Tibetans to high altitude hypoxia likely involves a group of genes in the hypoxic pathway, as suggested by earlier studies. To test the adaptive role of the previously reported candidate gene EP300 （histone acetyltransferase p300）, we conducted resequencing of a 108.9 kb gene region of EP300 in 80 unrelated Tibetans. The allele-frequency and haplotype-based neutrality tests detected signals of positive Darwinian selection on EP300 in Tibetans, with a group of variants showing allelic divergence between Tibetans and lowland reference populations, including Han Chinese, Europeans, and Africans. Functional prediction suggested the involvement of multiple EP300 variants in gene expression regulation. More importantly, genetic association tests in 226 Tibetans indicated significant correlation of the adaptive EP300 variants with blood nitric oxide （NO） concentration. Collectively, we propose that EP300 harbors adaptive variants in Tibetans, which might contribute to high-altitude adaptation through regulating NO production.

Analysis of sleep quality,disease uncertainty,and psychological tolerance in patients undergoing chemotherapy for digestive tract malignancies

BACKGROUND Colorectal cancer is the second leading cause of cancer-related deaths among digestive tract malignancies,following gastric cancer.Sleep is of great significance for maintaining human health.The incidence of sleep disorders in patients with cancer is approximately twice that observed in the general population.Lack of sleep can prolong hospital stays,increase the likelihood of infection,and increase mortality rates.Therefore,studying the factors related to sleep quality is significant for improving the quality of life of patients with malignant tumors of the digestive tract.AIM To investigate the relationships among sleep quality,disease uncertainty,and psychological resilience in patients undergoing chemotherapy for digestive tract malignancies.METHODS A total of 131 patients with malignant digestive tract tumors who were treated at Hefei BOE Hospital between April 2021 and September 2022 were selected as research participants.Based on their Pittsburgh Sleep Quality Index(PSQI)scores,participants were divided into either the sleep disorder group(PSQI score>7)or the normal sleep group(PSQI score≤7).The clinical data—together with the Mishel Uncertainty in Illness Scale for Adults(MUIS-A)and Connor-Davidson Resilience Scale(CD-RISC)scores—were compared.RESULTS In this study,78(59.54%)patients with digestive tract malignancies developed sleep disorders after chemotherapy.Sleep disorder incidence was higher in patients with colorectal cancer than in those with gastric and esophageal cancers(P<0.05).The total MUIS-A score and those for each item in the sleep disorder group were higher than those in the normal sleep group.The total CD-RISC score and those for each item in the sleep disorder group were lower than those in the normal sleep group(P<0.05).The PSQI scores of patients with malignant digestive tract tumors were positively correlated with the scores for lack of disease information,disease uncertainty,and unpredictability in the MUIS-A and negatively correlated with the scores for tenacity,self-improvement,and optimism in the CD-RISC(P<0.05).CONCLUSION Patients undergoing chemotherapy for digestive tract malignancies are prone to sleep problems related to disease uncertainty and psychological resilience.Therefore,interventions can be implemented to improve their sleep quality.