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High plasma fibrinogen concentration and platelet count unfavorably impact survival in non–small cell lung cancer patients with brain metastases 被引量:18
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作者 Jian-Fei Zhu Ling Cai +4 位作者 Xue-Wen Zhang Yin-Sheng Wen Xiao-Dong Su Tie-Hua Rong Lan-Jun Zhang 《Chinese Journal of Cancer》 SCIE CAS CSCD 2014年第2期96-104,共9页
High expression of fibrinogen and platelets are often observed in non–small cell lung cancer(NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of ... High expression of fibrinogen and platelets are often observed in non–small cell lung cancer(NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of this study were to evaluate the prognostic significance of plasma fibrinogen concentration and platelet count, as well as to determine the overall survival of NSCLC patients with brain metastases. A total of 275 NSCLC patients with brain metastasis were enrolled into this study. Univariate analysis showed that high plasma fibrinogen concentration was associated with age ≥ 65 years(P = 0.011), smoking status(P = 0.009), intracranial symptoms(P = 0.022), clinical T category(P = 0.010), clinical N category(P = 0.003), increased partial thromboplastin time(P < 0.001), and platelet count(P < 0.001). Patients with low plasma fibrinogen concentration demonstrated longer overall survival compared with those with high plasma fibrinogen concentration(median, 17.3 months versus 11.1 months; P ≤ 0.001). A similar result was observed for platelet counts(median, 16.3 months versus 11.4 months; P = 0.004). Multivariate analysis showed that both plasma fibrinogen concentration and platelet count were independent prognostic factors for NSCLC with brain metastases(R2 = 1.698, P < 0.001 and R2 = 1.699, P < 0.001, respectively). Our results suggest that high plasma fibrinogen concentration and platelet count indicate poor prognosis for NSCLC patients with brain metastases. Thus, these two biomarkers might be independent prognostic predictors for this subgroup of NSCLC patients. 展开更多
关键词 血浆纤维蛋白原 非小细胞肺癌 血小板计数 生存期 患者 浓度 单因素分析
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Recursive Partitioning Analysis Classification and Graded Prognostic Assessment for Non-Small Cell Lung Cancer Patients with Brain Metastasis:A Retrospective Cohort Study 被引量:4
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作者 Cai-xing Sun Tao Li +4 位作者 Xiao Zheng Ju-fen Cai Xu-li Meng Hong-jian Yang Zheng Wang 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2011年第3期177-182,共6页
Objective:To assess prognostic factors and validate the effectiveness of recursive partitioning analysis (RPA) classes and graded prognostic assessment (GPA) in 290 non-small cell lung cancer (NSCLC) patients w... Objective:To assess prognostic factors and validate the effectiveness of recursive partitioning analysis (RPA) classes and graded prognostic assessment (GPA) in 290 non-small cell lung cancer (NSCLC) patients with brain metastasis (BM).Methods:From Jan 2008 to Dec 2009,the clinical data of 290 NSCLC cases with BM treated with multiple modalities including brain irradiation,systemic chemotherapy and tyrosine kinase inhibitors (TKIs) in two institutes were analyzed.Survival was estimated by Kaplan-Meier method.The differences of survival rates in subgroups were assayed using log-rank test.Multivariate Cox's regression method was used to analyze the impact of prognostic factors on survival.Two prognostic indexes models (RPA and GPA) were validated respectively.Results:All patients were followed up for 1-44 months,the median survival time after brain irradiation and its corresponding 95% confidence interval (95% CI) was 14 (12.3-15.8) months.1-,2-and 3-year survival rates in the whole group were 56.0%,28.3%,and 12.0%,respectively.The survival curves of subgroups,stratified by both RPA and GPA,were significantly different (P0.001).In the multivariate analysis as RPA and GPA entered Cox's regression model,Karnofsky performance status (KPS) ≥ 70,adenocarcinoma subtype,longer administration of TKIs remained their prognostic significance,RPA classes and GPA also appeared in the prognostic model.Conclusion:KPS ≥70,adenocarcinoma subtype,longer treatment of molecular targeted drug,and RPA classes and GPA are the independent prognostic factors affecting the survival rates of NSCLC patients with BM. 展开更多
关键词 Non-small cell lung cancer (NSCLC) brain metastasis PROGNOSIS Recursive partitioning analysis Graded prognostic assessment
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Surgery Versus Stereotactic Radiosurgery for Single Synchronous Brain Metastasis from Non-Small Cell Lung Cancer 被引量:1
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作者 Hui LI Sheng-cai HOU Bin HU Tong LI Yang Wang Jin-bai Miao Bin You Yi-li Fu 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2009年第1期56-60,共5页
Objective: The aim of this study is to compare the effectiveness of surgery with stereotactic radiosurgery (SRS) for patients with a single synchronous brain metastasis from successfully treated non-small cell lung... Objective: The aim of this study is to compare the effectiveness of surgery with stereotactic radiosurgery (SRS) for patients with a single synchronous brain metastasis from successfully treated non-small cell lung cancer. Methods: Between 1995 and 2002, 53 patients underwent resection of both primary non-small cell lung cancer and the associated single brain metastasis. There were 33 men and 20 women with a mean age of 57 years (range, 32-85 years). At the time of diagnosis, 42 patients experienced lung cancer related symptoms, whereas 11 patients experienced brain metastases-related symptoms. 42 patients had received thoracic surgery first, and 11 patients had undergone neurosurgery or radiosurgery first. Pneumonectomy was performed in 9 out of 42 patients (21.4%), lobectomies in 30 (71.4%), and wedge resection in 3 (7.2%). 48 patients (90.5%) underwent complete lymphadenectomy. 35 patients underwent brain metastasectomy. 18 underwent SRS. Results: There was no postoperative mortality and severe complications after either lung or brain surgery. Histology showed 34 adenocarcinomas, 16 squamous cell carcinomas, and 3 large cell lung cancers. 15 patients (28.3%) had no evidence of lymph node metastases (No), 20 patients (37.7%) had hilar metastases (N1), and 18 patients (34%) had mediastinal metastases (N2). The 1-, 2-, 3- and 5-year overall survival rates were 49%, 19%, 10%, and 5%, respectively. The corresponding data for neurosurgery group were 55%, 17%, 11%, and 6%, respectively. The median survival time was 13 months. For SRS group the corresponding data were 44.8%, 20.9% 10.5%, and 2%, respectively. The median survival time was 14 months. The differences between the two groups were not significant (P〉0.05). In lymph node negative patients (No), the overall 5-year survival rate was 10%, as compared with a 1% survival rate in patients with lymph node metastases (N1-2). The difference was significant (P〈0,01). For adenocarcinomas, the 5-year survival rate was 5%. The correspondent data for squamous cell lung cancers was 3%. The difference was not significant (P〉0.05). Conclusion: Although the overall survival rate for patients who have brain metastases from NSCLC is poor, surgical resection or radiosurgery may be beneficial in a select group of patients with synchronous brain metastases and lung cancer without lymph node metastases. 展开更多
关键词 Non-small cell lung cancer (NSCLC) Synchronous brain metastasis SURGERY Stereotacticradiosurgery (SRS)
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Small-Molecule Ligands as Challenge for Positron Emission Tomography of Peptide Receptors in Neurons and Microglia of the Brain
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作者 Margit Pissarek 《World Journal of Neuroscience》 2019年第4期294-327,共34页
Neuropeptide and chemokine receptors of the G protein-coupled receptor (GPCR) family belong to different classes and subgroups providing different docking sites and special binding behavior at extracellular and also t... Neuropeptide and chemokine receptors of the G protein-coupled receptor (GPCR) family belong to different classes and subgroups providing different docking sites and special binding behavior at extracellular and also transmembrane domains for small molecules potentially suitable for positron emission tomography (PET). The contribution gives an overview updating developments of small-molecule, nonpeptide ligands at a selection of peptide and chemokine receptors, expressed in neurons and microglia of the brain, regarding the last five years. Orexin 1 and orexin 2 receptors (OX1R;OX2R) and neuropeptide Y1 and Y2 receptors (NPY1R, NPY2R) were chosen as representatives of Class A neuropeptide receptors, chemokine receptor CX3C (CX3CR1) as Class A, protein-activated receptor, highly expressed in activated microglia, and corticotropin releasing factor receptor 1 (CRFR1) as representative Class B1 receptor. Structural differences between binding domains and their endogenous ligands as well as parallel expression in different types of cells and generally low density of these receptors in brain tissue are factors making the search for selective and sensitive ligands more difficult than for classical GPCR receptors. Main progress in ligand development is observed for NPY receptor antagonists and orexin receptor antagonists. For orexin receptors, search for suitable ligands can be supported with modelling approaches, as recently the complete molecular structure of these receptors is available. Small molecules, binding at CRFR1, as for other Class B1 receptor ligands, in PET and investigations of pharmacodynamics revealed rather allosteric binding modes, although, the complete crystal structure of CRFR1 as prototype of Class B1 provides, hitherto, improved possibilities for understanding binding mechanisms. Highly specific as a marker of microglia among?the GPCRs, CX3CR1 is focused as target of PET during inflammation of brain and spinal cord. 展开更多
关键词 POSITRON Emisson Tomography brain small-MOLECULE Ligand Peptide RECEPTORS Neuron MICROGLIA
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Small Molecule-Assisted PET: Approaches to Imaging of Conformational Diseases of the Brain
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作者 Margit Pissarek 《World Journal of Neuroscience》 2017年第1期106-139,共34页
PET (positron emission tomography) in vivo imaging of cerebral conformational diseases is essentially based on non-peptide small molecule ligands used to detect early alterations in peptide secondary structures and su... PET (positron emission tomography) in vivo imaging of cerebral conformational diseases is essentially based on non-peptide small molecule ligands used to detect early alterations in peptide secondary structures and subsequent accumulation of aberrant oligomers and protein deposits involved in progressive neurodegeneration, cognitive and movement disorders. In this article, an overview is given about tracers currently available and lead structures of potential PET probes for detection of?β-amyloid (Aβ), tau protein, α-synuclein, constitutive (PrPc) and infectious isoforms (PrPsc) of prions (proteinaceous infectious particles) as imaging targets. Whereas the styrylpyridine derivative florbetapir, approved for clinical applications, the stilbene derivative florbetaben and the benzoxazole derivative BF227 show high affinity binding to Aβ, preclinical investigations promise improved pharmacokinetics for benzoimidazothiazoles, aryloxazoles and benzofuran derivatives. Tau protein imaging based clinically, presently, on the pyridine-pyridoindole T807 has got new incentives following identification of a series of pyrrolopyridine quinolines and pharmacokinetic improvements of fluoropropoxy quinolines including for instance THK-5351. The pyridine isoquinoline MK6240 is involved now in clinical trials. Most forward-looking efforts apply to small molecule ligands of α-synuclein, which are expected to permit a breakthrough in differential diagnostics of Parkinson-related dementia and Lewy body diseases. However, at the moment the proposed lead structures are in affinity and blood brain barrier delivery properties below the possibilities of Aβ?and tau protein ligands. This is the case also for potential tracers of prion proteins. 展开更多
关键词 Conformational Diseases PET small Molecule LIGANDS brain TAU Protein Α-SYNUCLEIN PRP
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Is There Any Indication for Prophylactic Brain Irradiation in the Management of Small Cell Prostate Cancer?
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作者 Joseph Kattan Hampig Kourie +2 位作者 Pierre Sarkis Joseph Gharios Joelle Antoun 《Journal of Cancer Therapy》 2013年第4期1-2,共2页
Small cell prostate carcinoma (SCPC) is an extremely rare pathology with an aggressive behavior, characterized by early brain metastases. We describe three cases of SCPC where brain metastases occurred despite respons... Small cell prostate carcinoma (SCPC) is an extremely rare pathology with an aggressive behavior, characterized by early brain metastases. We describe three cases of SCPC where brain metastases occurred despite response to chemotherapy. The benefit of prophylactic brain irradiation (PBI), as part of the management of SCPC, is discussed and compared to its indications in small cell lung cancer. 展开更多
关键词 small Cell Carcinoma Prostate Cancer brain METASTASES PROPHYLACTIC brain IRRADIATION
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Icotinib, an EGFR-TKI, for the treatment of brain metastases in non-small cell lung cancer:a retrospective study
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作者 Qunhui Wang Hua Zheng +4 位作者 Ying Hu Baohua Lu Fanbin Hu Hongmei Zhang Baolan Li 《Oncology and Translational Medicine》 2016年第6期268-274,共7页
Objective Treatment of brain metastases from non-small cell lung cancer(NSCLC) is a challenge because of the poor prognosis. Icotinib is a new type of oral epidermal growth factor receptor(EGFR) tyrosine kinase inhibi... Objective Treatment of brain metastases from non-small cell lung cancer(NSCLC) is a challenge because of the poor prognosis. Icotinib is a new type of oral epidermal growth factor receptor(EGFR) tyrosine kinase inhibitor(TKI) used in the treatment of advanced NSCLC. The aim of this study was to evaluate the efficacy of icotinib in NSCLC patients with brain metastasis.Methods This study reviewed records of 51 NSCLC patients with brain metastases who took icotinib 125 mg, 3 times a day. Response rate, progression free survival, and overall survival were analyzed. SPSS software version 17.0 was used for univariate analysis, and Cox regression analysis to analyze factors affecting survival. Results Thirty-six cases had partial response, 6 cases had stable disease, and 10 cases had progressive disease. In 31 cases, EGFR gene mutation test were performed. EGFR was mutated in 26 cases and was with wild-type in 5 cases. In patients with EGFR mutations, 23 patients responded to icotinib [the disease control rate(DCR) was 88.5%], significantly higher than in patients with wild-type EGFR(1 patient, DCR 20%)(P = 0.005). The overall median progression-free survival(PFS) was 7.6 months. PFS was longer in the patients with EGFR mutations than in those with wild type EGFR(7.8 months vs 1.2 months, P = 0.03). The overall median overall survival(OS) time was 10.7 months. OS was longer in patients with EGFR mutations than in those with wild type EGFR(15.1 months vs 6.7 months, P = 0.003). The main side effects of the treatment were skin rash and diarrhea; no stage 3 or 4 toxic effects occurred. Univariate analysis demonstrated that OS was related to sex, Eastern Cooperative Oncology Group performance status(ECOG PS), smoking history, and EGFR mutation. Multivariate analysis showed that OS was independently related to sex, ECOG PS, and EGFR mutations.Conclusion Icotinib has a favorable effect on NSCLC patients with brain metastases harboring EGFR mutations. Icotinib can be a new choice of treatment for brain metastases in patients with NSCLC harboring EGFR mutations. 展开更多
关键词 non-small cell lung cancer(NSCLC) brain metastases ICOTINIB epidermal growth factor receptor(EGFR)
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基于脑MRI的机器学习预测非小细胞肺癌T790M突变
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作者 崔婀娜 杨春娜 +3 位作者 王晓煜 沙宪政 赵鹏 孙艺瑶 《中国临床医学影像杂志》 CAS CSCD 北大核心 2024年第3期153-159,共7页
目的:本研究基于脑部T_(1)C和T_(2)W MRI建立人工智能模型,预测肺癌脑转移患者在靶向治疗中的耐药性T790M突变。方法:本研究收集80例肺癌脑转移患者(2017年6月—2019年12月)的T_(1)C和T_(2)W MRI影像和临床数据进行回顾性分析(患者按照2... 目的:本研究基于脑部T_(1)C和T_(2)W MRI建立人工智能模型,预测肺癌脑转移患者在靶向治疗中的耐药性T790M突变。方法:本研究收集80例肺癌脑转移患者(2017年6月—2019年12月)的T_(1)C和T_(2)W MRI影像和临床数据进行回顾性分析(患者按照2∶1的比例分成训练集和测试集)。采用无监督k-means算法将肿瘤区域划分为高亮度区域和低亮度区域,提取不同区域的影像组学图像特征构建模型,评估每个模型的诊断效果。绘制受试者工作特征(Receiver operating characteristic,ROC)曲线,计算ROC曲线下面积(Area under curve,AUC)、特异性和敏感性作为模型评价指标,分析模型的潜在临床应用价值。结果:对T_(1)C和T_(2)W MRI和临床特征融合的统计计算表明,本研究建立的模型对T790M突变具有良好的预测能力,在训练集和测试集上的AUC分别为0.899和0.818。结论:本研究建立的计算机模型可以有效预测肺癌脑转移患者T790M突变,具有潜在的临床辅助诊断价值。 展开更多
关键词 非小细胞肺 脑肿瘤 肿瘤转移 磁共振成像
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基于fMRI图论网络探索脑小血管病性轻度认知障碍的虚、实证候拓扑属性对照研究
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作者 王建军 杨卫敏 +5 位作者 郑浩涛 陈建湘 蔡东滨 吕涵青 秦秀德 刘兰英 《世界科学技术-中医药现代化》 CSCD 北大核心 2024年第1期69-75,共7页
目的基于图论网络探索性分析皮质下脑小血管病性轻度认知障碍虚证、实证的全脑及局部脑网络拓扑属性组间差异。方法前瞻性招募诊断为皮层下小血管病所致轻度血管性认知障碍患者和健康对照,基于GRETNA平台,计算虚证、实证和健康对照比较... 目的基于图论网络探索性分析皮质下脑小血管病性轻度认知障碍虚证、实证的全脑及局部脑网络拓扑属性组间差异。方法前瞻性招募诊断为皮层下小血管病所致轻度血管性认知障碍患者和健康对照,基于GRETNA平台,计算虚证、实证和健康对照比较的组间全局小世界拓扑属性和局部节点强度、节点效率的组间差异。结果三组均具有小世界属性,但仅实证组患者在稀疏度为0.05-0.26内小世界属性δ显著低于对照组(P<0.05);同时,涉及额、顶及小脑等多个脑区的节点效率和节点强度指标均显著区分实证组、虚证组,但虚证患者在节点效率上无阳性脑区(P>0.05),在节点强度上仅表现为少数脑区的节点效率增高(P<0.05)。结论实组在全局拓扑属性及局部拓扑属性上均显著有别于虚证组,说明虚实证候具有显著差异的影像表型,为进一步探讨中医证候在疾病生物学分型的作用提供研究基础。 展开更多
关键词 脑小血管病 认知障碍 证候 脑网络 小世界
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奥西替尼联合全脑放疗对非小细胞肺癌的疗效分析
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作者 侯志华 张莹 +1 位作者 魏红艳 魏晗 《河北医药》 CAS 2024年第17期2610-2613,共4页
目的探讨奥西替尼联合全脑放疗对非小细胞肺癌的治疗效果。方法选取2019年6月至2020年6月确诊为非小细胞肺癌并伴随脑转移的86例患者,随机数字表法分为试验组和对照组,每组43例。对照组采取常规化疗方式联合全脑放疗进行治疗,试验组在... 目的探讨奥西替尼联合全脑放疗对非小细胞肺癌的治疗效果。方法选取2019年6月至2020年6月确诊为非小细胞肺癌并伴随脑转移的86例患者,随机数字表法分为试验组和对照组,每组43例。对照组采取常规化疗方式联合全脑放疗进行治疗,试验组在常规化疗联合全脑放疗的基础上联合奥西替尼治疗,比较2组患者的近期疗效、血清肿瘤标志物含量、不良反应情况以及生存情况。结果试验组治疗有效率为88.4%高于对照组的62.8%(P<0.05)。试验组患者血清的CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)显著高于对照组(P<0.05);试验组的血清CYFRA21-1水平显著低于对照组(P<0.05)。试验组的患者的无病生存时间中位数为8个月,对照组为5个月,Log-rank检验显示,试验组的无病生存时间显著高于对照组(P<0.05)。结论奥西替尼联合全脑放疗作为治疗非小细胞肺癌脑转移患者的治疗方式,治疗效果较好,能延长患者的无病生存时间并且能提高患者的生存质量,值得临床推广应用。 展开更多
关键词 非小细胞肺癌 奥西替尼 全脑放疗
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非小细胞肺癌脑转移高危因素分析
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作者 周开甲 周冰 +4 位作者 陈泽磊 陈昭芳 陈婷 陈溥 张鸿辉 《现代医药卫生》 2024年第20期3459-3463,共5页
目的分析影响非小细胞肺癌(NSCLC)脑转移的高危因素。方法回顾性分析2020-2024年福建医科大学肿瘤临床医学院/福建省肿瘤医院/复旦大学附属肿瘤医院福建医院收治的258例NSCLC患者的性别、年龄等临床及病理类型、分子病理信息,结合采用... 目的分析影响非小细胞肺癌(NSCLC)脑转移的高危因素。方法回顾性分析2020-2024年福建医科大学肿瘤临床医学院/福建省肿瘤医院/复旦大学附属肿瘤医院福建医院收治的258例NSCLC患者的性别、年龄等临床及病理类型、分子病理信息,结合采用的治疗方式,综合分析影响NSCLC脑转移的高危因素。结果(1)年轻、女性患者,EGFR突变及ALK基因重排NSCLC患者,脑转移发生率上升。(2)年轻NSCLC患者出现脑膜转移的风险较高,EGFR突变NSCLC患者出现脑膜转移的风险显著增加。(3)针对NSCLC脑转移患者,在靶向治疗的基础上,配合脑部放疗、抗肿瘤血管生成及免疫治疗;而如果患者出现脑膜转移,在靶向治疗的基础进行抗肿瘤血管生成治疗。结论NSCLC脑转移的高危因素包括年轻、女性、EGFR突变及合并ALK重排突变。通过早期识别和干预这些高危因素,有助于提高NSCLC脑转移患者的生存率和生活质量。 展开更多
关键词 非小细胞肺癌 高危因素 脑转移 治疗方式 预后
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阿托伐他汀联合胞磷胆碱治疗脑小血管病轻度认知障碍疗效观察 被引量:1
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作者 邓琳 丁昊 辜忠灵 《中国实用神经疾病杂志》 2024年第4期473-477,共5页
目的 分析阿托伐他汀联合胞磷胆碱治疗脑小血管病(CSVD)轻度认知障碍(MCI)的疗效及对患者血-脑屏障功能和炎症因子的影响。方法 选取2021-03—2023-03自贡市第四人民医院收治的102例CSVD合并MCI患者为研究对象,分为观察组与对照组各51... 目的 分析阿托伐他汀联合胞磷胆碱治疗脑小血管病(CSVD)轻度认知障碍(MCI)的疗效及对患者血-脑屏障功能和炎症因子的影响。方法 选取2021-03—2023-03自贡市第四人民医院收治的102例CSVD合并MCI患者为研究对象,分为观察组与对照组各51例。对照组口服胞磷胆碱钠片,观察组在对照组基础上加用阿托伐他汀钙片口服,2组均持续治疗3个月。治疗结束后比较2组患者临床疗效,以及治疗前、治疗3个月后蒙特利尔评定量表(MoCA)评分、血-脑屏障功能、炎症因子水平[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)]和血脂水平[总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)],记录治疗期间不良反应。结果 治疗后观察组总有效率优于对照组(94.12%比78.43%,P<0.05)。2组患者MoCA评分较治疗前均显著升高,观察组为(27.07±1.05)分,高于对照组的(25.89±1.54)分(P<0.05)。2组患者治疗后伊文思蓝水平、血清CRP、IL-6水平、血清TC、TG和LDL-C水平较治疗前均降低,观察组分别为(10.29±1.17)μg/g、(4.67±1.03)mg/L、(101.76±10.54)ng/L、(2.06±0.46)mmol/L、(1.65±0.32)mmol/L、(1.84±0.30)mmol/L,均低于对照组的(13.87±1.56)μg/g、(6.93±1.78)mg/L、(109.34±11.12)ng/L、(3.24±0.49)mmol/L、(2.24±0.48)mmol/L、(2.39±0.46)mmol/L(P<0.05)。2组患者治疗期间相关不良反应发生率无统计学差异(7.84%比5.88%,P>0.05)。结论 阿托伐他汀联合胞磷胆碱治疗CSVD合并MCI疗效确切,有利于改善患者认知功能、血-脑屏障功能,并降低炎症因子和脂质代谢水平。 展开更多
关键词 脑小血管病轻度认知障碍 阿托伐他汀 胞磷胆碱 血-脑屏障功能 炎症因子
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脑小血管病患者血清lncRNA BIRF,lncRNA FAL1表达水平与脑白质病变程度的相关性分析
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作者 张晓璇 魏依兰 +4 位作者 于宁 韩玥莹 姚雪 刘瑶 窦志杰 《现代检验医学杂志》 CAS 2024年第6期102-107,共6页
目的探究脑小血管病(CSVD)患者血清长链非编码RNA(lncRNA)脑缺血相关因子(BIRF)、1号染色体上的局部扩增lncRNA(lncRNA FAL1)表达与脑白质病变(WML)程度的相关性分析。方法选取承德医学院附属医院2021年6月~2023年6月收治的102例CSVD患... 目的探究脑小血管病(CSVD)患者血清长链非编码RNA(lncRNA)脑缺血相关因子(BIRF)、1号染色体上的局部扩增lncRNA(lncRNA FAL1)表达与脑白质病变(WML)程度的相关性分析。方法选取承德医学院附属医院2021年6月~2023年6月收治的102例CSVD患者,根据WML诊断标准将CSVD患者分为WML组(n=72)和非WML组(n=30)。并根据Fazekas评分进一步将WML组分为轻度WML组(n=24)、中度WML组(n=36)和重度WML组(n=12)。采用实时荧光定量聚合酶链式反应(RT-qPCR)检测血清中lncRNA BIRF,lncRNA FAL1水平;采用Pearson相关分析血清lncRNA BIRF,lncRNA FAL1水平的相关性。采用受试者工作特征(ROC)曲线分析血清lncRNA BIRF,lncRNA FAL1水平对CSVD患者发生重度WML的诊断价值。结果WML组患者年龄(70.50±5.86岁)、高血压史(有/无:43/29例)、糖尿病史(有/无:45/27例)、IL-33(68.35±6.80 pg/ml),IL-18(97.78±9.65 ng/L)、泛素羧基末端水解酶L1(UCH-L1)(0.29±0.10μg/L),lncRNA BIRF水平(2.45±0.30)显著高于非WML组(67.10±5.76岁,11/19例,9/21例,62.48±6.13 pg/ml,92.56±9.37 ng/L,0.24±0.06μg/L,1.02±0.11),血清lncRNA FAL1表达(0.52±0.10)显著低于非WML组(1.04±0.15),差异具有统计学意义(t=2.683,4.518,8.978,4.085,2.510,2.550,25.346,20.500,均P<0.05)。轻度WML组、中度WML组、重度WML组CSVD患者血清lncRNA BIRF水平(2.23±0.23,2.47±0.31,2.82±0.42)依次升高,血清lncRNA FAL1水平(0.60±0.15,0.51±0.09,0.40±0.04)依次降低,差异具有统计学意义(F=14.913,13.899,均P<0.05)。Pearson相关分析,WML组患者血清lncRNA BIRF与lncRNA FAL1水平呈负相关(r=-0.603,P<0.001);WML患者血清lncRNA BIRF与Fazekas评分呈正相关(r=0.483,P<0.001),血清lncRNA FAL1与Fazekas评分呈负相关(r=-0.507,P<0.001)。血清lncRNA BIRF,lncRNA FAL1水平单独及二者联合诊断CSVD患者发生重度WML的AUC(95%CI)分别为0.756(0.641~0.850),0.839(0.733~0.915)和0.892(0.796~0.953),二者联合检测优于血清lncRNA BIRF单独检测(Z=2.111,P=0.035)。结论CSVD伴WML患者血清lncRNA BIRF水平显著升高,lncRNA FAL1水平显著降低,均与CSVD患者WML程度相关。 展开更多
关键词 脑小血管病 长链非编码RNA脑缺血相关因子 1号染色体上的局部扩增lncRNA 脑白质病变
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番茄红素调节JAK2/STAT3/VEGF信号通路对脑小血管病大鼠血脑屏障和神经损伤的影响
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作者 刘传芬 宋征宇 +1 位作者 张晓丽 胡瑾 《中国免疫学杂志》 CAS CSCD 北大核心 2024年第11期2343-2349,共7页
目的:探讨番茄红素调节Janus激酶2(JAK2)/信号转导和转录激活因子3(STAT3)/血管内皮生长因子(VEGF)信号通路对脑小血管病(CSVD)大鼠血脑屏障和神经损伤的影响。方法:通过同种系微栓子体外注入法制备50只CSVD大鼠模型,随机分为模型组、... 目的:探讨番茄红素调节Janus激酶2(JAK2)/信号转导和转录激活因子3(STAT3)/血管内皮生长因子(VEGF)信号通路对脑小血管病(CSVD)大鼠血脑屏障和神经损伤的影响。方法:通过同种系微栓子体外注入法制备50只CSVD大鼠模型,随机分为模型组、番茄红素低剂量(65 mg/kg)组、番茄红素高剂量(85 mg/kg)组、AG490(JAK2抑制剂,3.5 mg/kg)组、番茄红素高剂量(85 mg/kg)+AG490(3.5 mg/kg)组,每组10只,另选取10只SD大鼠作为假手术组,以番茄红素和AG490分组处理后,采用Morris水迷宫实验和避暗实验检测大鼠认知能力;伊文思蓝法检测大鼠血脑屏障通透性;尼氏染色检测大鼠海马神经元数量;试剂盒检测大鼠脑组织炎症因子前列腺素E2(PGE2)、肿瘤坏死因子-α(TNF-α)及氧化应激因子过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平;免疫印迹法检测大鼠脑组织基质金属蛋白酶(MMP)2、MMP9、紧密连接相关蛋白(ZO-1、Occludin)及JAK2/STAT3/VEGF通路相关蛋白表达。结果:与假手术组比较,模型组大鼠穿台次数、目标象限停留时间、步入潜伏期、海马神经元数量、脑组织CAT与SOD水平、ZO-1与Occludin、VEGF蛋白表达、p-JAK2/JAK2、p-STAT3/STAT3显著降低(P<0.05),错误次数、伊文思蓝含量、脑组织PGE2、TNF-α、MDA水平及MMP2、MMP9蛋白表达显著升高(P<0.05)。与模型组比较,番茄红素低剂量组、番茄红素高剂量组大鼠穿台次数、目标象限停留时间、步入潜伏期、海马神经元数量、脑组织CAT与SOD水平、ZO-1与Occludin、VEGF蛋白表达、p-JAK2/JAK2、p-STAT3/STAT3均升高(P<0.05),错误次数、伊文思蓝含量、脑组织PGE2、TNF-α、MDA水平及MMP2、MMP9蛋白表达均降低(P<0.05),且高剂量番茄红素作用更强;AG490组大鼠各指标变化趋势与番茄红素各剂量组相反,且AG490可逆转番茄红素的作用。结论:番茄红素可通过激活JAK2/STAT3/VEGF信号通路抑制CSVD大鼠炎症与氧化应激,从而减轻其血脑屏障和神经损伤,并提升其认知能力。 展开更多
关键词 番茄红素 JAK2/STAT3/VEGF 脑小血管病 血脑屏障 神经损伤
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机器人引导下穿刺引流10~30 mL脑内小血肿的临床研究
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作者 丘琪政 颜华 +3 位作者 张光宇 凌文峰 程凤燕 陈兵 《中国现代手术学杂志》 2024年第2期115-119,共5页
目的探讨机器人引导下穿刺引流10~30 mL脑内小血肿的临床效果。方法采用回顾性病例对照研究。选取2019年1月至2022年12月在梅州市人民医院接受治疗的83例高血压脑出血患者,依据治疗方法不同分为机器人手术组(观察组)39例和保守治疗组(... 目的探讨机器人引导下穿刺引流10~30 mL脑内小血肿的临床效果。方法采用回顾性病例对照研究。选取2019年1月至2022年12月在梅州市人民医院接受治疗的83例高血压脑出血患者,依据治疗方法不同分为机器人手术组(观察组)39例和保守治疗组(对照组)44例。比较两组患者临床效果、住院期间并发症发生情况、住院时间及住院费用、出院时及出院3个月时基础性日常生活能力量表(basic activity of daily living scale,BADL)评分及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分。结果①入院时两组NIHSS评分和BADL评分无统计学差异(P>0.05);但出院时、出院3个月随访时观察组NIHSS评分更低(P<0.05),BADL评分更高(P<0.05)。②观察组和对照组的平均住院时间分别为(12.8±3.3)d和(13.8±4.0)d,两组比较无统计学差异(P=0.252)。观察组和对照组的住院费用分别为(38496.23±6369.06)元和(19258.36±4068.68)元,观察组高于对照组(P<0.05)。③观察组和对照组的并发症发生率分别为2.6%(1/39)和6.8%(3/44)。观察组发生穿刺行程区出血1例,对照组并发肺部感染3例,两组比较无统计学差异(P>0.05)。结论机器人引导下穿刺引流10~30 mL脑内小血肿的疗效较好,术后并发症少,操作便捷简单,可促进患者术后功能的恢复,有效提高患者的生活质量。 展开更多
关键词 高血压脑出血 脑内小血肿 机器人辅助 血肿腔穿刺
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HTRA丝氨酸肽酶1基因杂合突变致相关脑小血管病一家系报道
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作者 胡娟娟 李轲 +3 位作者 曾晓霞 李萍 胡帅 漆学良 《中国脑血管病杂志》 CAS CSCD 北大核心 2024年第10期688-692,共5页
HTRA丝氨酸肽酶1(HTRA1)相关脑小血管病(CSVD)较罕见,尽早诊断和治疗可改善预后。作者报道南昌大学第二附属医院神经内科收治的1例37岁、男性患者,以一过性右侧肢体无力为首发症状,影像学提示脑白质病变,基因检测显示HTRA1(c.854 C>T... HTRA丝氨酸肽酶1(HTRA1)相关脑小血管病(CSVD)较罕见,尽早诊断和治疗可改善预后。作者报道南昌大学第二附属医院神经内科收治的1例37岁、男性患者,以一过性右侧肢体无力为首发症状,影像学提示脑白质病变,基因检测显示HTRA1(c.854 C>T/p.Pro285Leu)杂合突变,最终诊断为HTRA1相关CSVD。对其家系成员进行调查,其特点为:罹患缺血性脑血管病,伴颈椎、腰椎间盘突出,男性患者伴脱发,部分患者存在认知功能障碍,男性比女性发病年龄早,发病年龄逐代提前。因此,对于青年缺血性脑血管病伴随脱发、认知功能障碍、颈椎或腰椎间盘突出,影像学提示明显脑白质病变,尤其不伴有常见脑血管病危险因素的患者,应追问家族史,并进行基因检测筛查HTRA1基因突变位点。 展开更多
关键词 大脑小血管病 脑梗死 HTRA丝氨酸肽酶1 突变 误义 遗传性脑小血管病
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不同剂量脑立体定向放疗联合PD-1/PD-L1抑制剂治疗非小细胞肺癌脑转移的疗效及安全性
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作者 付小娜 魏涛 +4 位作者 赵世杰 冯连杰 刘维鹏 赵晓园 朱青山 《实用癌症杂志》 2024年第5期819-822,共4页
目的不同剂量脑立体定向放疗联合PD-1/PD-L1抑制剂治疗非小细胞肺癌脑转移的疗效及安全性。方法选取50例非小细胞肺癌脑转移患者作为研究对象,根据患者脑立体定向放疗分割剂量分为A组(n=15)、B组(n=15)和C组(n=20),患者均接受脑立体定... 目的不同剂量脑立体定向放疗联合PD-1/PD-L1抑制剂治疗非小细胞肺癌脑转移的疗效及安全性。方法选取50例非小细胞肺癌脑转移患者作为研究对象,根据患者脑立体定向放疗分割剂量分为A组(n=15)、B组(n=15)和C组(n=20),患者均接受脑立体定向放疗联合生存PD-1/PD-L1抑制剂治疗,A组脑立体定向放疗剂量为4 Gy/f,12 f,B组为5 Gy/f,8 f组,C组为7 Gy/f,5 f。对比三组患者治疗后临床疗效、不良反应发生率以及生存情况;对比三组患者治疗前后KPS评分。结果三组患者临床总有效率比较差异具有统计学意义(P<0.05);C组临床总有效率比较显著高于A组和B组(P<0.05);三组患者不良反应总发生率对比差异无统计学意义(P>0.05);A组、B组和C组患者中位生存期分别为2.70个月、2.40个月和6.60个月。Log-rank检验结果提示,三组患者中位生存期比较,差异具有统计学意义(P<0.05);治疗后,三组患者的KPS评分均显著升高,组间比较差异显著,且C组患者较A组和B组显著更高(P<0.05)。结论对于非小细胞肺癌脑转移患者,7 Gy/f,5 f分割剂量相比于4 Gy/f,12 f和5 Gy/f,8 f联合PD-1/PD-L1抑制剂改善患者的临床疗效更明显,延长生存时间和生存质量更为明显。 展开更多
关键词 脑立体定向放疗 PD-1/PD-L1抑制剂 非小细胞肺癌 脑转移
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HTRA丝氨酸肽酶1基因杂合突变相关脑小血管病一例
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作者 陈若梦 苏旭东 +1 位作者 仇福成 刘晓云 《中国脑血管病杂志》 CAS CSCD 北大核心 2024年第7期467-471,共5页
报道1例诊断为HTRA丝氨酸肽酶1(HTRA1)基因杂合突变相关脑小血管病(CSVD)的52岁女性患者。该例患者既往无高血压病、糖尿病史,无烟酒嗜好;其外祖父、外祖母为近亲结婚,外祖母及母亲死于脑梗死;临床表现为复发性脑梗死、轻度认知障碍,头... 报道1例诊断为HTRA丝氨酸肽酶1(HTRA1)基因杂合突变相关脑小血管病(CSVD)的52岁女性患者。该例患者既往无高血压病、糖尿病史,无烟酒嗜好;其外祖父、外祖母为近亲结婚,外祖母及母亲死于脑梗死;临床表现为复发性脑梗死、轻度认知障碍,头部MRI示多发腔隙性脑梗死、广泛脑白质变性和微出血病灶;全外显子组基因检测报告示HTRA1 c.947A>G杂合突变。对于CSVD患者应追问其家族史,对疑似遗传性CSVD患者,需考虑存在HTRA1基因杂合突变的可能;并合理借助基因检测方法,筛选CSVD高危家族患者并进一步指导治疗。 展开更多
关键词 大脑小血管疾病 脑梗死 HTRA丝氨酸肽酶1 突变 误义 遗传性脑小血管病
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基于心与小肠相表里探讨脑肠轴与阿尔茨海默病
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作者 耿赫利 王蕾 《光明中医》 2024年第18期3800-3803,共4页
阿尔茨海默病(Alzheimer’s disease,AD)是一种起病隐匿、进展缓慢、进行性加重的神经退行性病变。大量研究表明,肠道菌群可通过脑肠轴调控中枢神经系统,从而参与AD的发生发展。中医经典理论“心与小肠相表里”认为无论是在生理、病理... 阿尔茨海默病(Alzheimer’s disease,AD)是一种起病隐匿、进展缓慢、进行性加重的神经退行性病变。大量研究表明,肠道菌群可通过脑肠轴调控中枢神经系统,从而参与AD的发生发展。中医经典理论“心与小肠相表里”认为无论是在生理、病理还是经络方面,心与小肠都紧密相关。此文通过阐述“心与小肠相表里”与脑肠轴的相关性,探讨肠道菌群与AD的关系,以期为防治AD探索新思路,并为从脾论治AD提供一定的理论支撑。 展开更多
关键词 痴呆 阿尔茨海默病 心与小肠相表里 脑肠轴 肠道菌群
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血清CA125、CA199、CYFRA-21及CEA联合检测对非小细胞肺癌患者脑转移的诊断价值
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作者 许慧婧 袁萍 郑婷婷 《实用癌症杂志》 2024年第8期1290-1292,共3页
目的分析糖类抗原125(CA125)、糖类抗原199(CA199)、细胞角蛋白19片段(CYFRA-21)、癌胚抗原(CEA)对非小细胞肺癌(NSCLC)患者脑转移的诊断价值。方法选取NSCLC患者共96例,根据其是否存在脑转移将其划分为转移组(32例)及未转移组(64例);... 目的分析糖类抗原125(CA125)、糖类抗原199(CA199)、细胞角蛋白19片段(CYFRA-21)、癌胚抗原(CEA)对非小细胞肺癌(NSCLC)患者脑转移的诊断价值。方法选取NSCLC患者共96例,根据其是否存在脑转移将其划分为转移组(32例)及未转移组(64例);另将行体检的75例健康体检者纳入健康组。抽取全部研究对象的晨起空腹静脉血,检测血清CA125、CA199、CYFRA-21及CEA水平。绘制受试者工作曲线(ROC),分析CA125、CA199、CYFRA-21、CEA联合检测对NSCLC患者脑转移的诊断价值。结果转移组的CA125、CA199、CYFRA-21、CEA水平高于未转移组、健康组,且未转移组的CA125、CA199、CYFRA-21、CEA水平高于健康组,差异有统计学意义(P<0.05)。ROC结果显示,CA125、CA199、CYFRA-21、CEA联合检测诊断NSCLC患者脑转移的曲线下面积(AUC)高于CA125、CA199、CYFRA-21、CEA单独诊断。结论CA125、CA199、CYFRA-21、CEA在出现脑转移的NSCLC患者血清中的表达较高,四者联合检测能够有效诊断出患者是否存在脑转移,具有一定的诊断价值。 展开更多
关键词 非小细胞肺癌 脑转移 受试者工作曲线 细胞角蛋白19片段 癌胚抗原
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