Determination of volumetric elastic moduli of plant leaf cells based on pressure-volume curves

Volumetric elastic modulus （VEM） is an important parameter in biophysics and biomechanics of plants for in particular understanding cell growth. This paper proposes a new relation that can be used for precisely determining VEM. With the aid of this relation, it shows that the exponential approximation of the pressure-volume relationship adopted in most of the literatures in this field may lead to serious errors on VEM.

Determination of Carboplatin Dose by Area Under the Curve in Combination Chemotherapy for Senile Non-small Cell Lung Cancer

To preliminarily determine the appropriate dosage of carboplatin （CBP） at AUC of 5 mg-M1^-1·min^-1 in the combination chemotherapy for Chinese senile patients with non-small cell lung cancer （NSCLC）. Thirty-five Chinese senile patients with NSCLC in advanced stage （Ⅲ/Ⅳ） were given 96 cycles of combination chemotherapy. Chemotherapy schedules included Taxol＋CBP, Gemzar＋CBP and NVB＋CBE The dose of CBP was at 5 mg.mL^-1·min^-1 of area under the concentration-time curve （AUC）. Side effects and quality of life were observed before and after the chemotherapy. Myelosuppression was severe and commonly observed. Grade 3/4 of granulocytopenia was found in 47.9% （46/96） of the patients and grade 3/4 of thrombocytopenia was noted in 28.1% （27/96） of the subjects. However, other side effects were slight. The mean score of quality of life （QOL）, according to the criteria of QOL for Chinese cancer patients had reduced 6.8. At 5 mg.mL^-1·min^-1 by AUC, the hematological toxicity of CBP was severe and it had some negative effects on the QOL. The administration of CBP at 5 mg.mL^-1·min^-1 by AUC may be too high for Chinese senile patients with non-small cell lung cancer.

From Pressure-Volume Relationship to Volume-Energy Relationship: A Thermo-Statistical Model for Alveolar Micromechanics

The connective tissue fiber system and the surfactant system are essential and interdependent components of lung elasticity. Despite considerable efforts over the last decades, we are still far from understanding the quantitative roles of either the connective tissue fiber or the surfactant systems. Through thermo-statistic considerations of alveolar micromechanics, the author introduced a thermo-statistic state function “entropy” to analyze the elastic property of pulmonary parenchyma based on the origami model of alveolar polyhedron. By use of the entropy for alveolar micromechanics, from the logistic equation for the static pressure (P)-volume (V) curves including parameters a, b, c, and k (V - a = b/[1+ exp{-k (P - c)}]), a set of equations was obtained to define the internal energy of lungs (UL) and its corresponding lung volume (VL). Then, by use of parameters a, b, c, and k, an individual volume-internal energy (VL - UL) diagram was constructed from reported data in patients on mechanical ventilation. Each VL - UL diagram constructed was discussed that its minimal value Uo = c (a + b/2) and its shape parameter b/k represent quantitatively the energy of tissue force and the energy of surface force. Furthermore, by use of the VL - UL relationship, the hysteresis of lungs estimated by entropy production was discussed as dependent on the difference in the number of contributing pulmonary lobules. That is, entropy production might be a novel quantitative indicator to estimate the dynamics of the bronchial tree. These values obtained by combinations of parameters of the logistic P-V curve seem useful indicators to optimize setting a mechanical ventilator. Thus, it is necessary to develop easy tools for fitting the individual sigmoid pressure-volume curve measured in the intensive care unit to the logistic equation.

肺癌化疗患者血清TBNK淋巴细胞亚群水平变化与预后的相关性研究

目的:探究肺癌化疗患者血清TBNK淋巴细胞亚群水平变化,并分析其与预后的相关性。方法:分析2020年1月至2023年6月就诊于北京京煤集团总医院的92例肺癌化疗患者,行标准方案化疗,检测首次化疗前、化疗1、3个周期后TBNK淋巴细胞亚群水平,化疗结束后3个月评价预后,分为缓解组(63例)、未缓解组(29例),分析TBNK淋巴细胞亚群水平与预后的相关性。结果:Ⅲ期组化疗1、3个周期后CD3^(+)、CD3^(+)CD4^(+)、CD3^(-)CD19^(+)低于Ⅳ期组,CD3^(+)CD8^(+)、CD3^(-)CD16^(+)CD56^(+)高于Ⅳ期组(P<0.05);缓解组化疗1、3个周期后CD3^(+)、CD3^(+)CD4^(+)、CD3^(-)CD19^(+)低于未缓解组,CD3^(+)CD8^(+)、CD3^(-)CD16^(+)CD56^(+)高于未缓解组(P<0.05);肺癌化疗患者分期、预后与CD3^(+)、CD3^(+)CD4^(+)、CD3^(-)CD19^(+)呈正相关,与CD3^(+)CD8^(+)、CD3^(-)CD16^(+)CD56^(+)呈负相关(P<0.05);化疗3个周期后TBNK淋巴细胞亚群联合预测肺癌化疗患者预后的AUC最大,为0.907(P<0.05)。结论:肺癌化疗患者外周血TBNK淋巴细胞亚群变化与免疫功能状态及预后有关,监测相关指标水平可预测肺癌化疗患者预后。

肺部12分区超声评分与新生儿呼吸窘迫综合征病情程度的相关性及其诊断价值

目的探究肺部12分区超声评分与新生儿呼吸窘迫综合征(NRDS)病情程度的相关性及其诊断应用价值。方法选择2020年3月—2022年7月收治的NRDS患儿80例纳入NRDS组,另选取同期非肺部疾病的新生儿80例纳入对照组,所有新生儿均行胸部X线、肺部12分区超声评分及氧合指数检查。分析2组超声征象、血气氧合指数及肺部12分区超声评分,Spearman相关分析肺部12分区超声评分与NRDS病情程度的相关性,受试者工作特征曲线分析肺部12分区超声评分诊断不同病情程度NRDS患儿的效能。结果NRDS组支气管充气征、B线融合、A线消失、肺实变、弥漫性肺水肿、胸膜线异常检出率均高于对照组(P<0.01)。NRDS组氧合指数低于对照组,肺部12分区超声评分高于对照组(P<0.01)。重度患儿肺部12分区超声评分高于中度和轻度患儿,中度患儿高于轻度患儿(P<0.05);胸部X线分级与肺部12分区超声评分呈显著正相关(r=0.782,P<0.05)。重度患儿氧合指数低于中度和轻度患儿,中度患儿低于轻度患儿(P<0.05);氧合指数与肺部12分区超声评分呈显著负相关(r=-0.861,P<0.05)。肺部12分区超声评分诊断轻度、中度、重度NRDS患儿的曲线下面积分别为0.875、0.894、0.922。结论肺部12分区超声评分可全面、系统评价、准确反应NRDS患儿病情,临床依据该评分实时监测患儿病情,可为临床治疗提供重要信息和依据。

肺部超声B线数量与腹膜透析患者水肿指数、NT-proBNP相关性及在容量超负荷中的评估效能

目的探讨肺部超声B线数量与腹膜透析患者水肿指数、N末端脑钠肽前体(NT-proBNP)相关性及在容量超负荷中评估效能。方法按照1∶1选取2022年1月—2023年8月收治的50例尿毒症腹膜透析容量超负荷患者(超负荷组)、50例尿毒症腹膜透析容量非超负荷患者(对照组)作为研究对象,采用肺部超声检测2组B线数量。以Pearson简单线性关系分析B线数量与水肿指数、NT-proBNP水平的相关性,比较2组基线资料以及透析前后B线数量、水肿指数、NT-proBNP,偏相关性分析腹膜透析患者容量超负荷的相关影响因素,受试者工作特征曲线分析B线数量、水肿指数、NT-proBNP预测容量超负荷价值。结果透析前后B线数量与水肿指数、NT-proBNP均呈显著正相关(P<0.01);超负荷组血清白蛋白、尿素清除指数(Kt/V)低于对照组(P<0.01)。超负荷组透析前后B线数量、水肿指数、NT-proBNP均高于对照组,且2组透析后上述指标低于透析前(P<0.05)。校正了血清白蛋白、Kt/V后,B线数量、水肿指数、NT-proBNP仍与腹膜透析患者容量超负荷呈正相关(P<0.01)。B线数量、水肿指数、NT-proBNP预测腹膜透析患者容量超负荷的曲线下面积(AUC)分别为0.784、0.709、0.810,而三者联合的AUC为0.936,其预测敏感度为88.00%,特异度为90.00%(P<0.01)。结论肺部超声检测B线数量与腹膜透析患者水肿指数、NT-proBNP密切相关,均与患者容量超负荷有关,三者联合检测可提高对腹膜透析患者容量超负荷的预测能力,可为容量管理提供客观参考信息和决策支持。

Drought resistance of four grasses using pressure-volume curve

Pressure-volume curve(PV curve)technique is a major method for studying critical plant water potential and critical tissue water content when plasmolysis takes place.In the present study,a mathematical solution method is put forward to obtain parameters based on the PV curve.The cal-culated results for the parameters of Lolium perenne,Festuca arundinacea,Leymus chinensis and Stipa krylovii indicated that the mathematical solution method is convenient for actual research compared with the graphical method.Further analysis of the calculations suggested that drought resistance decreased in the following order:S.krylovii>F.arundinacea and L.chinensis>L.perenne.

Lung mechanics in canine oleic acid-induced respiratory distress syndrome model

In mechanically ventilated anesthetized dogs (pentobarbital sodium,30mg/kg) with acute lung injury induced by intravenous infusion of oleic acid(OA),changes in airflow,lung volume,and tracheal (Pao),transpulmonary (Ptp)and esophageal (Pes) pressures were measured.Changes in lung mechanics werestudied before and after OA infusion at intervals,during an observation periodlasting 4h,using curve-fitting method,interrupter technique and pressure-volume(PV) loops measurement.The main findings are listed as follows:(1)Complianceand functional residual capacity (FRC) showed a marked decrease,while Pao andPtp showed a marked increase within 2h after OA.(2) Airflow resistance atexpiratory phase estimated by the curve-fitting method showed a marked increaseafter OA.(3)PV loops of the lungs or total respiratory system showed similarchanges 4h after OA,characterized by the presence of an inflexion point at theinflation limb,increased hysteresis and rightward and downward shift of the loop.It is suggested that use of the curve-fitting method in combination with the PVloop for the total respiratory system would be more appropriate for monitoringlung mechanics during mechanical ventilatory support of ARDS patients.

Expression of STAT3 in non-small cell lung cancer and its clinical significance

Signal transducer and activator of transcription 3(STAT3) plays an important role in tumor occurrence and development. Here we attempt to evaluate the clinical diagnostic value of STAT3 as a potential tumor marker by detecting the expression of STAT3 in blood of non-small cell lung cancer (NSCLC) patients. Immunohistochemistry was applied to detect STAT3 protein in A549 cells and MRC-5 cell, real time PCR was applied to detect STAT3 mRNA and ELISA was applied to detect the expression of STAT3 protein in NSCLC patients, benign lung disease group and healthy controls. The expression levels of STAT3 mRNA and STAT3 protein in A549 cells and NSCLC patients were significantly higher (P < 0.01). The areas under ROC curves (Az) of STAT3 mRNA and STAT3 protein were 0.870 and 0.860 respectively, which had no significant difference (P > 0.05). When comparing the Az of STAT3 protein with CEA, CA125 and CYFRA21-1 respectively, there was no significant difference (P > 0.05). And we compared the Az of the four joint detection (STAT3 + CEA + CA125 + CYFRA21-1) with the three joint detection (CEA + CA125 + CYFRA21-1), 0.930 and 0.841, respectively, P < 0.05. It appears that the diagnostic value and accuracy of STAT3 is equivalent with CEA, CA125, and CYFRA21-1 in NSCLC, and to joint with other three can achieve higher diagnosis value.

Diagnostic and Prognostic Significance of Keapl mRNA Expression for Lung Cancer Based on Microarray and Clinical Information from Oncomine Database

We performed a bioinformatics analysis with validation by multiple databases,aiming to evaluate the diagnostic and prognostic value of Kelch-like ECH-associated protein 1(Keapl)mRNA for lung cancer,and to explore possible mechanisms.Diagnostic performance of Keapl mRNA was determined by receiver operating characteristic(ROC)curve analysis.Prognostic implication of Keapl mRNA was estimated by Kaplan-Meier survival analysis.Co-expressed genes with both Keapl and Nfe2L2 were identified by LinkedOmics.Mechanisms of Keapl-Nfe2L2-co-expressed genes underlying the pathogenesis of lung cancer were explored by function enrichment and pathway analysis.The ROC curve analysis determined a good diagnostic performance of Keapl mRNA for lung squamous cell carcinoma(LUSC),with an area under the ROC curve(AUC)of 0.833,sensitivity of 72.7%,and specificity of 90.6%(P<0.001).Multivariate Cox regression recognized high Keapl mRNA to be an independent risk factor of mortality for overall lung cancer[hazard ratio(HR):11.034,P=0.044],but an independent antagonistic factor for lung adenocarcinoma(LUAD)(HR:0.404,P<0.001).Validation by UALCAN and GEPIA supported Oncomine findings regarding the diagnostic value of Keapl mRNA for LUSC,but denied its prognostic value.After screening,we identified 17 co-expressed genes with both Keapl and Nfe2L2 for LUAD,and 22 for LUSC,mainly enriched in signaling pathway of oxidative stress-induced gene expression via Nrf2.In conclusion,Keapl mRNA has a good diagnostic performance,but controversial prognostic efficacy for LUSC.The pathogenesis of lung cancer is associated with Keapl-Nfe2L2-co-expressed genes by signaling pathway of oxidative stress-induced gene expression via Nrf2.

手绘画图导航引导经支气管镜肺活检的学习曲线分析

目的 探讨手绘画图导航引导经支气管镜肺活检的学习曲线。方法 纳入2022年6—10月于广州医科大学附属第一医院呼吸内镜中心进修且具备常规支气管镜操作经验的12名进修医师作为研究对象,分为超声对照组(单纯超声)和手绘画图组(画图导航+超声),各6名。采用累积和分析法(cumulative sum analysis,CUSUM)的方法对6名位进修医师分别完成15次手绘画图导航引导经支气管镜肺活检操作的学习曲线进行分析,对CUSUM曲线进行曲线拟合。结果12名进修医师共对126例肺外周结节患者进行活检操作(超声对照组36例,手绘画图组90例),两组患者的性别、年龄、病灶部位、病灶大小、操作成功率和术中并发症发生率差异无统计学意义(P>0.05)。与超声对照组相比,手绘画图组操作者的信心评分更高[(3.20±0.69)分vs.(2.86±0.80)分,P=0.019],气管镜操作时间更短[(363.89±117.64) s vs.(470.64±91.44) s,(P<0.001)]。经气管镜活检时间变化趋势图显示随画图导航操作例数的增加而呈下降趋势。学习曲线(系数R2为0.741)拟合模型显示,经过约8例画图导航引导气道镜操作后,操作时间CUSUM值穿过0点,分为学习提升阶段和熟练掌握阶段。与提升阶段相比,熟练阶段的操作时间明显缩短[(278.33±57.07) s vs.(461.67±89.14) s,(P<0.001)],画图时间减少[(3.35±1.50)s vs.(4.38±1.83) s,(P=0.004)],自信心评分明显增加[(3.40±0.61)分vs.(2.98±0.72)分,(P=0.003)]。结论 建立学习曲线指导画图支气管导航引导经支气管镜肺活检的技能培训安全、可行、有效,经过理论和操作培训以及8次实践操作后进入熟练掌握期,学员可独立熟练完成该项临床操作。

基于压力-容积曲线的个体化肺保护性通气在接受腹腔镜卵巢囊肿剥除术肥胖患者中的应用

目的探讨基于压力-容积曲线的个体化肺保护性通气在接受腹腔镜卵巢囊肿剥除术肥胖患者中的应用效果。方法选择2022年2月至2023年5月定州市人民医院收治的60例接受腹腔镜卵巢囊肿剥除术的肥胖患者为研究对象,按照随机数字表法分为两组,各30例。对照组实施容量控制模式机械通气,观察组采取基于压力-容积曲线的个体化肺保护性通气,比较两组动脉血氧分压、动脉血二氧化碳分压(PaCO2)水平及麻醉机呼吸参数和并发症发生情况。结果机控15 min、机控1 h及手术结束时两组的动脉血氧分压水平高于麻醉前,观察组高于对照组(P<0.05);观察组PaCO2、气道峰值压、气道平台压和平均气道压低于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05)。结论腹腔镜卵巢囊肿剥除术肥胖患者采取个体化的压力-容积曲线肺保护性通气,可有效改善机体氧合状态,维持内环境稳定,降低气道压及呼吸相关并发症的发生率。

支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术的学习曲线

目的 探讨具备单向式单操作孔胸腔镜肺癌根治术经验的治疗组开展支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术的学习曲线特征。方法 回顾性分析该手术团队2018年4月~2020年12月连续完成支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术98例资料,使用累积和法(cumulative sum, CUSUM)分析学习曲线,并对学习曲线不同阶段围手术期指标进行比较。结果 该学习曲线最佳拟合方程为:y=1.512+1.760x-1.775×10-2x2-1.222×10-5x3,拟合优度R2=0.976。根据该方程,连续实施48例本术式后可进入熟练阶段(第49~98例),之前为学习阶段(第1~48例)。熟练阶段淋巴结清扫个数多于学习阶段(P<0.05),而手术时间、术中出血量、切割缝合器钉匣数均少于学习阶段(P<0.05),2个阶段清扫淋巴结组数、中转开胸率、术后住院时间、术后并发症率差异均无显著性(P>0.05)。结论 在具备单向式单操作孔胸腔镜肺癌根治术经验的治疗组,经过48例手术后可熟练掌握支气管优先处理法单操作孔胸腔镜右肺上叶癌根治术。

四种肺癌预测模型对体检人群孤立性肺结节预测效能的比较

目的比较四种肺癌预测模型对孤立性肺结节(SPN)的预测效能。方法以健康体检中被诊断为SPN的体检者为研究对象,四种肺癌预测模型分别对SPN进行风险评估,前瞻性追踪随访SPN患者的临床结局。对四种肺癌预测模型中的风险因素进行统计描述及单因素分析,绘制ROC曲线及比较模型的检验效能。结果最终纳入479例SPN体检者,82例确诊为肺癌,恶性概率为17.12%。恶性组患者年龄、结节直径、吸烟、恶性肿瘤家族史、肺外肿瘤5年及以上、位于上叶、边界不清和毛刺比例高于良性结节组(P<0.05)。Brock模型预测效能最好,AUC为0.833,灵敏度80.49%,特异度74.31%,约登指数、阳性似然比、阳性预测值及阴性预测值最高,阴性似然比最低。Mayo模型AUC为0.815,灵敏度81.71%,特异度67.51%;PKUPH模型AUC为0.754,灵敏度69.51%,特异度73.55%;VA模型AUC为0.738,灵敏度68.29%,特异度67.55%。结论Brock模型对健康体检人群SPN风险预测效能提示最好,VA模型预测效能最差,Brock、Mayo和PKUPH三种模型的联合应用有待进一步研究。

中晚期肺癌患者姑息性表现发展轨迹研究

目的分析中晚期肺癌患者姑息性表现发展轨迹及其影响因素,为患者终末期护理提供指导。方法选取初诊后接受手术治疗的中晚期肺癌患者为调查对象,分别于术前(T1)、首次化疗周期前(T2)、首次化疗周期1~3 d(T3)、首次化疗周期中期(T4)、首次化疗周期结束(T5)和术后3个月(T6)6个时间点调查其姑息性表现。潜变量增长曲线混合模型分析其姑息性表现发展轨迹。结果中晚期肺癌患者T1时姑息性表现水平为(35.00±6.86)%,T2时(31.05±9.09)%,T3时(29.11±11.47)%,T4时30.00(10.00,50.00)%,T5时30.00(10.00,50.00)%,T6时20.00(10.00,50.00)%。中晚期肺癌患者姑息性表现发展曲线分为改善组(41.13%)、恶化组(22.58%)和严重恶化组(36.29%)。多分类logistic回归分析显示,年龄、TNM分期、人格分型和自我管理是肺癌患者姑息性表现类别的影响因素(均P<0.05)。结论中晚期肺癌患者姑息性表现整体呈随时间恶化发展趋势,根据不同时间点姑息性表现特征可分为改善组、恶化组和严重恶化组3个发展轨迹类别,高龄、情绪不稳定人格和低自我管理水平是中晚期肺癌患者姑息性表现的危险因素,应结合不同姑息性表现发展轨迹中晚期肺癌患者进行针对性干预,为其提供更优质的癌症护理。

血浆心脏型脂肪酸结合蛋白对非小细胞肺癌诊断和预后的价值研究

目的研究血浆心脏型脂肪酸结合蛋白(heart⁃type fatty acid⁃binding protein,H⁃FABP)对非小细胞肺癌(non⁃small cell lung cancer,NSCLC)诊断及患者预后的价值。方法回顾性分析2020年6月至2021年11月4海军军医大学第一附属医院收治的252例NSCLC患者(研究组)和270例非肺癌患者(对照组)的临床资料,采用受试者操作特征(receiver oper⁃ating characteristic,ROC)曲线和Logistic回归分析分析血浆H⁃FABP水平在NSCLC诊断和预后评估中的价值。结果血浆H⁃FABP水平诊断肺癌的曲线下面积(area under the curve,AUC)为0.74(95%CI:0.70~0.78,P<0.01)。有吸烟史、饮酒史、淋巴结转移以及TNM[T(肿瘤原发灶的情况,tumor),N(区域淋巴结受累情况,node),M(远处转移,metastasis)]分期较高的肺癌患者中血浆H⁃FABP水平较高(P>0.05)。单因素Logistic回归分析结果显示,年龄≥60岁、有吸烟史、有饮酒史、有淋巴结转移以及TNM分期Ⅲ/Ⅳ期、血浆H⁃FABP高水平与NSCLC患者预后不良有关(P<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁、有吸烟史、有饮酒史、有淋巴结转移、TNM分期为Ⅲ/Ⅳ期、血浆H⁃FABP高表达均是NSCLC患者预后不良的独立危险因素(P<0.05)。结论血浆H⁃FABP是NSCLC的诊断标志物,高水平的血浆H⁃FABP与NSCLC患者不良预后相关。

肺脏超声联合血清单核细胞趋化蛋白-1对重症社区获得性肺炎短期预后的预测价值

目的探究肺脏超声联合血清单核细胞趋化蛋白-1(MCP-1)对重症社区获得性肺炎(CAP)短期预后的预测价值。方法选取本院2019年3月~2022年11月收治的137例重症CAP患者。根据治疗28天后患者是否死亡将其分为生存组(n=86)和死亡组(n=51)。比较不同组别中临床资料、血清指标的差异。采用Pearson分析评估LUS评分、血清MCP-1水平与其他临床指标的相关性。采用二元Logistic分析评估CAP患者死亡的影响因素。采用受试者工作特征曲线(ROC)评估LUS评分、MCP-1对CAP患者28天死亡的预测价值。结果死亡组患者的SOFA评分、LUS评分及MCP-1较生存组升高,而氧合指数较生存组降低(P<0.05)。LUS评分、血清MCP-1水平与SOFA评分呈正相关,而与氧合指数呈负相关(P<0.05)。二元Logistic分析显示,SOFA评分、LUS评分及MCP-1是CAP患者28天发生死亡的危险因素(P<0.05)。ROC曲线显示,LUS评分、MCP-1联合诊断的AUC值明显高于单一LUS评分或MCP-1的AUC值,其灵敏度和特异度分别为80.39、81.40。结论随着重症CAP患者病情进展,LUS评分、血清MCP-1水平升高。同时,LUS评分、血清MCP-1水平是影响重症CAP患者短期预后的重要因素,对指导临床实践具有重要价值。

lncRNA UNC5B-AS1和miR-381在非小细胞肺癌组织中的表达及临床意义

目的探讨长链非编码RNA(lncRNA)非协调性分子5同源蛋白B-反义RNA1(UNC5B-AS1)和miR-381在非小细胞肺癌(NSCLC)组织中的表达及临床意义。方法采用实时荧光定量PCR(qPCR)检测NSCLC患者肿瘤组织(实验组)和肺良性肿瘤组织(对照组)lncRNA UNC5B-AS1和miR-381的表达差异;分析lncRNA UNC5B-AS1和miR-381的表达与NSCLC临床病理特征之间的关系;采用受试者工作特征(ROC)曲线评估lncRNA UNC5B-AS1和miR-381对NSCLC的诊断价值。采用多因素Cox回归模型分析影响NSCLC患者预后的独立因素。结果实验组lncRNA UNC5B-AS1的表达明显高于对照组(P<0001),而miR-381的表达明显低于对照组(P<0001)。lncRNA UNC5B-AS1和miR-381的表达呈明显负相关(r=-0352,P=0001)。lncRNA UNC5B-AS1、miR-381及两者联合诊断NSCLC的曲线下面积(AUC)分别为0860、0850和0924。LncRNA UNC5B-AS1与NSCLC患者的TNM分期、淋巴结转移及分化程度有关(P<005);miR-381与与NSCLC患者的肿瘤大小、淋巴结转移及分化程度有关(P<005)。lncRNA UNC5B-AS1高表达组患者的中位OS为269个月,明显低于低表达组的410个月(P<005);miR-381低表达组患者的中位OS为255个月,明显低于高表达组的420个月(P<005)。Cox多因素回归分析显示,肿瘤大小、TNM分期、淋巴结转移、lncRNA UNC5B-AS1表达及miR-381表达是影响NSCLC患者预后的独立因素(P<005)。结论在NSCLC组织中lncRNA UNC5B-AS1表达升高,而miR-381表达下降,两者对NSCLC有一定的诊断和预后预测价值。

非小细胞肺癌患者血清miR-130b、miR-937-5p表达及其诊断价值分析

目的探讨非小细胞肺癌(NSCLC)患者血清miR-130b、miR-937-5p表达水平及其临床诊断价值。方法选取2020年11月—2022年11月收治的NSCLC 100例作为NSCLC组,同期体检健康者100例作为对照组,采用RT-qPCR法检测miR-130b、miR-937-5p表达水平;采用Pearson法分析NSCLC患者血清miR-130b与miR-937-5p表达水平的相关性;采用受试者工作特征(ROC)曲线分析NSCLC患者血清miR-130b、miR-937-5p检测对NSCLC的诊断价值;行Cox回归分析探讨NSCLC发生的危险因素。结果与对照组相比,NSCLC组血清miR-130b、miR-937-5p表达水平升高(P<0.01)。相关性分析显示,NSCLC患者血清miR-130b与miR-937-5p表达水平呈正相关(r=0.672,P<0.01)。淋巴结转移、TNM分期Ⅲ~Ⅳ期、低分化NSCLC患者血清miR-130b、miR-937-5p表达水平显著高于淋巴结未转移、TNM分期Ⅰ~Ⅱ期、中高分化NSCLC患者(P<0.05,P<0.01)。血清miR-130b、miR-937-5p二者联合诊断NSCLC的曲线下面积高于单独诊断(Z=20.819,P<0.001;Z=4.328,P=0.037)。多因素Cox回归分析显示,分化程度及血清miR-130b、miR-937-5p表达水平是影响NSCLC发生的危险因素(P<0.01)。结论NSCLC患者血清miR-130b、miR-937-5p表达水平均升高,二者联合诊断NSCLC有较高的价值。

^(99)Tc^(m)-MIBI SPECT/CT双时相断层融合显像结合半定量分析鉴别肺磨玻璃结节良恶性

目的:探讨^(99)Tc^(m)-MIBI SPECT/CT显像结合靶区/本底比值(target/non-target,T/NT)半定量分析对肺磨玻璃结节(ground-glass nodule,GGN)良恶性的诊断价值。方法:收集我院2015年至2022年经平扫CT诊断为GGN的患者68例,注射^(99)Tc^(m)-MIBI后用SPECT/CT分别采集早期(15 min)和延迟期(3 h)断层同机融合图像,计算早期摄取比值(early uptake ratio,EUR)及延迟摄取比值(delayed uptake ratio,DUR)。然后根据病理结果将病灶分为良、恶性两组,比较两组对^(99)Tc^(m)-MIBI SPECT/CT显像的EUR和DUR,并对其诊断效能进行ROC曲线分析。结果:^(99)Tc^(m)-MIBI SPECT/CT同机融合显像发现恶性病灶55例,良性病灶13例,其对GGN良恶性鉴别诊断的灵敏度为98.1%,特异度为75.0%,准确性为92.6%,阳性预测值为92.7%,阴性预测值为92.3%。EUR(t=-2.841,P=0.006)和DUR(t=-3.525,P=0.001)对GGN良恶性鉴别的差异分析均有统计学意义。当EUR≥1.315或DUR≥1.145时,为诊断恶性肺部病灶的最佳截断值,其对应的灵敏度、特异度分别为54.2%、100.0%和79.2%、83.3%,曲线下面积分别为0.771和0.799。结论:^(99)Tc^(m)-MIBI SPECT/CT显像结合T/NT半定量分析对GGN良恶性诊断可提供一定的参考价值。