肺癌脑转移瘤的手术治疗效果及其预后因素分析

目的探讨肺癌脑转移瘤(BM)的手术治疗效果及其预后影响因素。方法回顾性分析北京天坛医院神经外科2013年1月—2018年12月手术治疗的123例肺癌脑转移瘤患者的临床资料。分析患者的生存时间及独立预后影响因素。结果本组患者术后的中位生存时间为22个月;1年、2年生存率分别为73.2%和35.8%。单因素分析显示,肺癌是否颅外转移、脑转移瘤的深浅部位、肺癌脑转移瘤的病理类型及脑转移瘤切除程度对患者的生存期有明显影响(P<0.05~0.001)。多因素Cox回归分析显示,肺癌是否颅外转移、脑转移瘤的深浅部位和转移瘤切除程度是影响患者预后的独立因素。结论肺癌脑转移瘤手术治疗能明显延长患者的生存期,而有肺癌颅外转移、深部脑转移瘤和转移瘤部分切除的患者预后较差。

脑出血血肿清除术后颅内感染影响因素及脑脊液NT-proBNP、NSE、LDH预测价值

目的 分析脑出血血肿清除术后颅内感染影响因素,探讨脑脊液N端脑钠肽前体(NT-proBNP)、神经元特异性烯醇化酶(NSE)、乳酸脱氢酶(LDH)对术后颅内感染的预测价值。方法 选取2017年1月-2020年12月台州市中心医院307例急性脑出血行血肿清除术患者,其中术后30 d颅内感染28例为感染组,279例为非感染组,分析颅内感染病原菌分布及影响因素,比较两组患者术后第2天脑脊液NT-proBNP、NSE、LDH水平差异及其预测术后颅内感染的临床价值。结果 28例颅内感染患者共分离36株病原菌,其中革兰阳性菌24株(66.67%)、革兰阴性菌11株(30.56%)、真菌1株(2.78%),多因素Logistic回归分析显示引流管留置时间、术前格拉斯哥昏迷评分(GCS)是导致急性脑出血患者血肿清除术后发生颅内感染的影响因素(P<0.05)。感染组术后第2天脑脊液NT-proBNP、NSE、LDH水平高于非感染组(P<0.05),联合检测预测急性脑出血血肿清除术后颅内感染的曲线下面积为0.843。结论 急性脑出血血肿清除术后发生颅内感染患者术后第2天脑脊液NT-proBNP、NSE、LDH水平高于未发生颅内感染患者,三者联合可作为预测颅内感染的生物标志物。

Antitumour effects on human colorectal carcinomas cells by stable silencing of phospholipase C-gamma 1 with lentivirus-delivered siRNA

Background In most colorectal carcinomas, the level of phospholipase C （PLC）-gamma 1 expression is greatly elevated. Increased expression of PLC-gamma 1 may play an important role in colon carcinogenesis, but the mechanism is not well known. The aim of this study was to evaluate the role of PLC-gamma 1 in colon carcinogenesis by using recombinant lentivirus that stably suppressed the PLC-gamma 1 expression in human colorectal carcinoma LoVo cells. Methods Recombinant lentivirus producing PLC-gamma 1 siRNA were prepared. After LoVo cells were transduced by each lentivirus, stably transduced cells were selected by Blasticidin. The protein and mRNA expression of PLC-gamma 1 were examined by Western-blot and reverse transcription-polymerase chain reaction （RT-PCR） analysis, and the effects of the lentivirus on the cell adhesion, migration and apoptosis were analyzed. Results Stable LoVo cell line deficient in PLC-gamma 1, was established. Notably, PLC-gamma 1 was silenced without affecting the levels of other subtypes of PLC so that the role of PLC-gamma 1 in colon carcinogenesis could be examined Silencing of endogenous PLC-gamma 1 resulted in efficient inhibition of the adhesion and migration of LoVo cells in vitro and a great increase of 5-fluorouracil induced apoptosis （30%-40%） of LoVo cells.Conclusions PLC-gamma 1 may play an important role in metastasis and anti-apoptosis in human colorectal carcinomas.