AIM: To investigate the expression of myofibrillogenesis regulator-1 (MR-1) in relation to clinicopathological parameters and postoperative survival in a group of Chinese patients with gastric cancer. METHODS: In our ...AIM: To investigate the expression of myofibrillogenesis regulator-1 (MR-1) in relation to clinicopathological parameters and postoperative survival in a group of Chinese patients with gastric cancer. METHODS: In our previous study of human wholegenome gene expression profiling, the differentially expressed genes were detected in the gastric cancer and its adjacent noncancerous mucosa. We found that MR-1 was associated with the location and differentiation of tumors. In this study, MR-1 protein expression was determined by immunohistochemistry in specimens of primary cancer and the adjacent noncancerous tissues from gastric cancer patients. A set of real-time quantitative polymerase chain reaction assays based on the Universal ProbeLibrary-a collection of 165 presynthesized, fluorescence-labeled locked nucleic acid hydrolysis probes-was designed specifically to detect the expression of MR-1 mRNA. The correlation was analyzed between the expression of MR-1 and other tumor characteristics which may influence the prognosis of gastric cancer patients. A retrospective cohort study on the prognosis was carried out and clinical data were collected from medical records. RESULTS: MR-1 mRNA and protein could be detected in gastric cancer tissues as well as in matched noncancerous tissues. MR-1 was up-regulated at both mRNA (5.459 ± 0.639 vs 1.233 ± 0.238, P < 0.001) and protein levels (34.2% vs 13.2%, P = 0.003) in gastric cancer tissues. Correlation analysis demonstrated that high expression of MR-1 in gastric cancer was significantly correlated with clinical stage (P = 0.034). Kaplan-Meier analysis showed that the postoperative survival of the MR-1 positive group tended to be poorer than that of the MR-1 negative group, and the difference was statistically significant (P = 0.002). Among all the patients with stageⅠ-Ⅳ carcinoma, the 5-year survival rates of MR-1 positive and negative groups were 50.40% and 12.70%, respectively, with respective median survival times of 64.27 mo (95%CI: 13.41-115.13) and 16.77 mo (95%CI: 8.80-24.74). Univariate and multivariate analyses were performed to compare the impact of MR-1 expression and other clinicopathological parameters on prognosis. In a univariate analysis on all 70 specimens, 6 factors were found to be significantly associated with the overall survival statistically: including MR-1 expression, depth of invasion, distant metastasis, lymph node metastasis, vascular invasion and the tumor node metastasis (TNM) stage based on the 7th edition of the International Union against Cancer TNM classification. To avoid the influence caused by univariate analysis, the expressions of MR-1 as well as other parameters were examined in multivariate Cox analysis. Clinicopathological variables that might affect the prognosis of gastric cancer patients were analyzed by Cox regression analysis, which showed that MR-1 expression and TNM stage were independent predictors of postoperative survival. The best mathematical multivariate Cox regression model consisted of two factors: MR-1 expression and TNM stage. Our results indicated that MR-1 protein could act as an independent marker for patient overall survival [Hazard ratio (HR): 2.215, P = 0.043]. CONCLUSION: MR-1 is an important variable that can be used to evaluate the outcome, prognosis and targeted therapy of gastric cancer patients.展开更多
In a large cohort of 1034 patients with the diagnosis of definite or probable amyotrophic lateral sclerosis (ALS), the association of forced vital capacity (FVC) at baseline with (a) time to progression of 20 points i...In a large cohort of 1034 patients with the diagnosis of definite or probable amyotrophic lateral sclerosis (ALS), the association of forced vital capacity (FVC) at baseline with (a) time to progression of 20 points in Appel ALS (AALS) score or (b) tracheostomy free survival was investigated. The median survival of ALS patients with baseline FVC < 75%was 2.91 years, compared with 4.08 years for patients with baselineFVC >75%(p < 0.001). Patients with baseline FVC < 75%progressed more rapidly (taking 8.0 months to progress 20 AALS points) compared with patients with baseline FVC >75%(10.0 months, p < 0.001). Moreover, FVC at first examination was identified as a significant predictor of survival and disease progression in both univariate and multivariate Cox regression models, after adjustment for age, sex, site of onset, diagnostic delay, riluzole therapy, and use of bilateral positive airway pressure and percutaneous endoscopic gastrostomy (p < 0.001). We conclude that a single FVC value obtained at an initial visit may serve as a clinically meaningful predictor of survival and disease progression in ALS.展开更多
OBJECTIVES: We sought to investigate the effect of cardiac medication on long-term mortality in patients with peripheral arterial disease(PAD). BACKGROUND: Peripheral arterial disease is associated with increased card...OBJECTIVES: We sought to investigate the effect of cardiac medication on long-term mortality in patients with peripheral arterial disease(PAD). BACKGROUND: Peripheral arterial disease is associated with increased cardiovascular morbidity and mortality. Treatment guidelines recommend aggressive management of risk factors and lifestyle modifications. However, the potential benefit of cardiac medication in patients with PAD remains ill defined. METHODS: In this prospective observational cohort study, 2,420 consecutive patients(age, 64± 11 years, 72% men) with PAD(ankle-brachial index ≤ 0.90) were screened for clinical risk factors and cardiac medication. Follow-up end point was death from any cause. Propensity scores for statins, beta-blockers, aspirin, angiotensin- converting enzyme(ACE) inhibitors, calcium channel blockers, diuretics, nitrates, coumarins, and digoxin were calculated. Cox regression models were used to analyze the relation between cardiac medication and long-term mortality. RESULTS: Medical history included diabetes mellitus in 436 patients(18% ), hypercholesterolemia in 581(24% ), smoking in 837(35% ), hypertension in 1,162(48% ), coronary artery disease in 1,065(44% ), and a history of heart failure in 214(9% ). Mean ankle-brachial index was 0.58(± 0.18). During a median follow-up of eight years, 1,067 patients(44% ) died. After adjustment for risk factors and propensity scores, statins(hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.36 to 0.58), beta-blockers(HR 0.68, 95% CI 0.58 to 0.80), aspirins(HR 0.72, 95% CI 0.61 to 0.84), and ACE inhibitors(HR 0.80, 95% CI 0.69 to 0.94)were significantly associated with a reduced risk of long-term mortality. CONCLUSIONS: On the basis of this observational longitudinal study, statins, beta-blockers, aspirins, and ACE inhibitors are associated with a reduction in long-term mortality in patients with PAD.展开更多
文摘目的 利用Cox回归分析模型和决策树模型探索中老年人群高血压发病的危险因素,比较两种方法的优劣。方法 基于2011—2015年中国健康与养老追踪调查数据,分别采用多元Cox回归模型和决策树模型分析高血压的危险因素。结果 2011—2015年之间高血压发病率为22.79%;Cox回归模型和决策树模型均显示年龄、教育程度、体质指数和糖尿病患病史是高血压发生的危险因素。Cox回归模型识别的危险因素还包括饮酒状况,决策树模型识别的危险因素还包括性别和婚姻状况。曲线下面积(Area Under the Curve,AUC)提示Cox回归模型和决策树模型预测高血压的能力接近。结论 高血压的危险因素包括性别、年龄、教育程度、婚姻状况、饮酒与否、体质指数和糖尿病患病史;根据Cox回归模型和决策树模型结果建立的高血压预测模型效能无差异。
基金Supported by The National 863 Program, Nos. SQ2009AA02-XK1482570 and 2006AA02A402Beijing Municipal Committee of Science and Technology, No. D0905001040631Beijing Capital Development Foundation of Health Bureau, No.2007-2051
文摘AIM: To investigate the expression of myofibrillogenesis regulator-1 (MR-1) in relation to clinicopathological parameters and postoperative survival in a group of Chinese patients with gastric cancer. METHODS: In our previous study of human wholegenome gene expression profiling, the differentially expressed genes were detected in the gastric cancer and its adjacent noncancerous mucosa. We found that MR-1 was associated with the location and differentiation of tumors. In this study, MR-1 protein expression was determined by immunohistochemistry in specimens of primary cancer and the adjacent noncancerous tissues from gastric cancer patients. A set of real-time quantitative polymerase chain reaction assays based on the Universal ProbeLibrary-a collection of 165 presynthesized, fluorescence-labeled locked nucleic acid hydrolysis probes-was designed specifically to detect the expression of MR-1 mRNA. The correlation was analyzed between the expression of MR-1 and other tumor characteristics which may influence the prognosis of gastric cancer patients. A retrospective cohort study on the prognosis was carried out and clinical data were collected from medical records. RESULTS: MR-1 mRNA and protein could be detected in gastric cancer tissues as well as in matched noncancerous tissues. MR-1 was up-regulated at both mRNA (5.459 ± 0.639 vs 1.233 ± 0.238, P < 0.001) and protein levels (34.2% vs 13.2%, P = 0.003) in gastric cancer tissues. Correlation analysis demonstrated that high expression of MR-1 in gastric cancer was significantly correlated with clinical stage (P = 0.034). Kaplan-Meier analysis showed that the postoperative survival of the MR-1 positive group tended to be poorer than that of the MR-1 negative group, and the difference was statistically significant (P = 0.002). Among all the patients with stageⅠ-Ⅳ carcinoma, the 5-year survival rates of MR-1 positive and negative groups were 50.40% and 12.70%, respectively, with respective median survival times of 64.27 mo (95%CI: 13.41-115.13) and 16.77 mo (95%CI: 8.80-24.74). Univariate and multivariate analyses were performed to compare the impact of MR-1 expression and other clinicopathological parameters on prognosis. In a univariate analysis on all 70 specimens, 6 factors were found to be significantly associated with the overall survival statistically: including MR-1 expression, depth of invasion, distant metastasis, lymph node metastasis, vascular invasion and the tumor node metastasis (TNM) stage based on the 7th edition of the International Union against Cancer TNM classification. To avoid the influence caused by univariate analysis, the expressions of MR-1 as well as other parameters were examined in multivariate Cox analysis. Clinicopathological variables that might affect the prognosis of gastric cancer patients were analyzed by Cox regression analysis, which showed that MR-1 expression and TNM stage were independent predictors of postoperative survival. The best mathematical multivariate Cox regression model consisted of two factors: MR-1 expression and TNM stage. Our results indicated that MR-1 protein could act as an independent marker for patient overall survival [Hazard ratio (HR): 2.215, P = 0.043]. CONCLUSION: MR-1 is an important variable that can be used to evaluate the outcome, prognosis and targeted therapy of gastric cancer patients.
文摘In a large cohort of 1034 patients with the diagnosis of definite or probable amyotrophic lateral sclerosis (ALS), the association of forced vital capacity (FVC) at baseline with (a) time to progression of 20 points in Appel ALS (AALS) score or (b) tracheostomy free survival was investigated. The median survival of ALS patients with baseline FVC < 75%was 2.91 years, compared with 4.08 years for patients with baselineFVC >75%(p < 0.001). Patients with baseline FVC < 75%progressed more rapidly (taking 8.0 months to progress 20 AALS points) compared with patients with baseline FVC >75%(10.0 months, p < 0.001). Moreover, FVC at first examination was identified as a significant predictor of survival and disease progression in both univariate and multivariate Cox regression models, after adjustment for age, sex, site of onset, diagnostic delay, riluzole therapy, and use of bilateral positive airway pressure and percutaneous endoscopic gastrostomy (p < 0.001). We conclude that a single FVC value obtained at an initial visit may serve as a clinically meaningful predictor of survival and disease progression in ALS.
文摘OBJECTIVES: We sought to investigate the effect of cardiac medication on long-term mortality in patients with peripheral arterial disease(PAD). BACKGROUND: Peripheral arterial disease is associated with increased cardiovascular morbidity and mortality. Treatment guidelines recommend aggressive management of risk factors and lifestyle modifications. However, the potential benefit of cardiac medication in patients with PAD remains ill defined. METHODS: In this prospective observational cohort study, 2,420 consecutive patients(age, 64± 11 years, 72% men) with PAD(ankle-brachial index ≤ 0.90) were screened for clinical risk factors and cardiac medication. Follow-up end point was death from any cause. Propensity scores for statins, beta-blockers, aspirin, angiotensin- converting enzyme(ACE) inhibitors, calcium channel blockers, diuretics, nitrates, coumarins, and digoxin were calculated. Cox regression models were used to analyze the relation between cardiac medication and long-term mortality. RESULTS: Medical history included diabetes mellitus in 436 patients(18% ), hypercholesterolemia in 581(24% ), smoking in 837(35% ), hypertension in 1,162(48% ), coronary artery disease in 1,065(44% ), and a history of heart failure in 214(9% ). Mean ankle-brachial index was 0.58(± 0.18). During a median follow-up of eight years, 1,067 patients(44% ) died. After adjustment for risk factors and propensity scores, statins(hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.36 to 0.58), beta-blockers(HR 0.68, 95% CI 0.58 to 0.80), aspirins(HR 0.72, 95% CI 0.61 to 0.84), and ACE inhibitors(HR 0.80, 95% CI 0.69 to 0.94)were significantly associated with a reduced risk of long-term mortality. CONCLUSIONS: On the basis of this observational longitudinal study, statins, beta-blockers, aspirins, and ACE inhibitors are associated with a reduction in long-term mortality in patients with PAD.
