为探讨女性绝经后骨质疏松症(postmenopausal osteoporosis PMO)患者骨密度(bone mineral density BMD)和性激素水平的变化与不同肾虚证型之间的内在联系,为临床辨证论治提供客观诊断依据。选择88例肾虚证PMO患者为研究对象,其中肾气虚...为探讨女性绝经后骨质疏松症(postmenopausal osteoporosis PMO)患者骨密度(bone mineral density BMD)和性激素水平的变化与不同肾虚证型之间的内在联系,为临床辨证论治提供客观诊断依据。选择88例肾虚证PMO患者为研究对象,其中肾气虚组37例,肾阴虚组29例,肾阳虚组22例,另设对照组30例,同步检测骨密度、血清睾酮(T)和雌二醇(E2),计算E2／T并进行统计学分析。结果PMO患者骨密度随肾气虚、肾阴虚、肾阳虚依次下降,其中肾阳虚组较对照组和肾气虚组显著下降(P<0.01);PMO不同肾虚证型组骨密度变化均为Want>Neck>Troch。与对照组比较,不同肾虚证型组T显著升高(P<0.01),性激素T水平的变化按肾气虚、肾阴虚、肾阳虚逐渐升高,而E2、E2／T则逐渐降低;不同肾虚证型组E2、E2／T较对照组显著下降(P<0.01)。表明①PMO患者骨密度随肾气虚、肾阴虚、肾阳虚依次下降,不同肾虚证型组骨密度变化均为Troch>Neck>Ward;②PMO患者性激素T水平的变化按肾气虚、肾阴虚、肾阳虚逐渐升高,而E2、E2／T则逐渐降低;③骨密度和性激素水平反应了肾虚程度,即依肾气虚-肾阴虚-肾阳虚逐渐加重。④骨密度测定值和性激素水平的变化可作为PMO不同肾虚证型的客观评价指标,并为PMO患者不同肾虚证型的治疗效果的观察提供参考依据。展开更多
Background： Good＇s syndrome （GS） is a rare disease characterized by thymoma, hypogammaglobulinemia, low or absent B-cells, decreased T-cells, an inverted CD4＋/CD8＋ T-cell ratio and redtlced T-cell mitogen prolif...Background： Good＇s syndrome （GS） is a rare disease characterized by thymoma, hypogammaglobulinemia, low or absent B-cells, decreased T-cells, an inverted CD4＋/CD8＋ T-cell ratio and redtlced T-cell mitogen proliferative responses. GS is difficult to diagnose preoperatively due to its rarity and lack of typical symptoms, tile characteristics of Chinese GS patients are still lacking. This study aimed to systematically review all the clinical, laboratory, and immunologic findings of reported cases of＂ Chinese patients with GS. Methods： We searched for case reports and articles up to January 2017 using PubMed, China National Knowledge Infrastructure, Wangfang database and China Science and Technology Journal Database with the following words in combinations as key words： ＂thymoma,＂ ＂hypogammaglobulinemia,＂ and ＂Good＇s syndrome.＂ The text words and MeSH terms were entered depending on the databases characteristics. The reference lists from retrieved articles were also screened for additional applicable studies. The authors were restricted to Chinese. There was no language restriction. Results： Forty-seven patients were reported in 27 studies. We found that GS has a nationwide distribution and that most cases （83%） have been described on the mainland of China. The initial clinical presentation is varied, ranging from symptoms related to the thymoma to infections resulting from immunodeficiency. Type AB （50%） is the most common histologic type ofthymomas in Chinese GS patients according to the World Health Organization classification ofthymomas. With respect to infection, sinopulmonary infection （74%） is the most common type, followed by skin infection （10%） and intestinal tract infection （10%）. Dian＇hea was presented in 36% of patients, and autoimmune manifestations were presented in 36% of patients. Conclusions： GS is a rare association of thymoma and immunodeficiency with a poor prognosis. Astute clinical acumen and increased awareness of the clinical and immun展开更多
目的探讨中医辨证治疗晚期结直肠癌化疗失败患者循环肿瘤DNA(ctDNA)状态、突变基因及其与预后相关性。方法收集83例晚期结直肠癌化疗失败患者外周血10ml,利用定制的覆盖416个肿瘤相关基因探针的Geneseeq One NGS面板进行杂交富集。高效...目的探讨中医辨证治疗晚期结直肠癌化疗失败患者循环肿瘤DNA(ctDNA)状态、突变基因及其与预后相关性。方法收集83例晚期结直肠癌化疗失败患者外周血10ml,利用定制的覆盖416个肿瘤相关基因探针的Geneseeq One NGS面板进行杂交富集。高效捕获后进行聚合酶链式反应(PCR)扩增,在HiSeq NGS平台(Illumina)上对目标富集的文库进行测序。结果在纳入的83例经中医辨证治疗的晚期结直肠癌化疗失败患者中,有54例(65.06%)血浆中检测出肿瘤相关突变基因,共152个基因。根据突变频率筛选出APC、TP53、KRAS、PIK3CA等前20位的基因;ctDNA突变频率、肿瘤突变负荷(TMB)、KRAS、PIK3CA均与预后显著相关(P<0.05);临床相关因素分析显示,肝转移与多个肿瘤基因不良突变相关(P<0.05或P<0.01),脾肾两虚证与ctDNA突变频率、TMB、TP53相关(P<0.05),八纲辨证中阴证、阳证与TMB相关(P<0.05)。结论外周血ctDNA可以较好地反映中医辨证治疗的晚期结直肠癌化疗失败患者分子生物学状态,脾肾两虚证与较低的ctDNA突变频率、较低的抑癌基因突变存在相关性;阴证患者TMB较低,阳证患者TMB较高。展开更多
文摘为探讨女性绝经后骨质疏松症(postmenopausal osteoporosis PMO)患者骨密度(bone mineral density BMD)和性激素水平的变化与不同肾虚证型之间的内在联系,为临床辨证论治提供客观诊断依据。选择88例肾虚证PMO患者为研究对象,其中肾气虚组37例,肾阴虚组29例,肾阳虚组22例,另设对照组30例,同步检测骨密度、血清睾酮(T)和雌二醇(E2),计算E2／T并进行统计学分析。结果PMO患者骨密度随肾气虚、肾阴虚、肾阳虚依次下降,其中肾阳虚组较对照组和肾气虚组显著下降(P<0.01);PMO不同肾虚证型组骨密度变化均为Want>Neck>Troch。与对照组比较,不同肾虚证型组T显著升高(P<0.01),性激素T水平的变化按肾气虚、肾阴虚、肾阳虚逐渐升高,而E2、E2／T则逐渐降低;不同肾虚证型组E2、E2／T较对照组显著下降(P<0.01)。表明①PMO患者骨密度随肾气虚、肾阴虚、肾阳虚依次下降,不同肾虚证型组骨密度变化均为Troch>Neck>Ward;②PMO患者性激素T水平的变化按肾气虚、肾阴虚、肾阳虚逐渐升高,而E2、E2／T则逐渐降低;③骨密度和性激素水平反应了肾虚程度,即依肾气虚-肾阴虚-肾阳虚逐渐加重。④骨密度测定值和性激素水平的变化可作为PMO不同肾虚证型的客观评价指标,并为PMO患者不同肾虚证型的治疗效果的观察提供参考依据。
文摘Background： Good＇s syndrome （GS） is a rare disease characterized by thymoma, hypogammaglobulinemia, low or absent B-cells, decreased T-cells, an inverted CD4＋/CD8＋ T-cell ratio and redtlced T-cell mitogen proliferative responses. GS is difficult to diagnose preoperatively due to its rarity and lack of typical symptoms, tile characteristics of Chinese GS patients are still lacking. This study aimed to systematically review all the clinical, laboratory, and immunologic findings of reported cases of＂ Chinese patients with GS. Methods： We searched for case reports and articles up to January 2017 using PubMed, China National Knowledge Infrastructure, Wangfang database and China Science and Technology Journal Database with the following words in combinations as key words： ＂thymoma,＂ ＂hypogammaglobulinemia,＂ and ＂Good＇s syndrome.＂ The text words and MeSH terms were entered depending on the databases characteristics. The reference lists from retrieved articles were also screened for additional applicable studies. The authors were restricted to Chinese. There was no language restriction. Results： Forty-seven patients were reported in 27 studies. We found that GS has a nationwide distribution and that most cases （83%） have been described on the mainland of China. The initial clinical presentation is varied, ranging from symptoms related to the thymoma to infections resulting from immunodeficiency. Type AB （50%） is the most common histologic type ofthymomas in Chinese GS patients according to the World Health Organization classification ofthymomas. With respect to infection, sinopulmonary infection （74%） is the most common type, followed by skin infection （10%） and intestinal tract infection （10%）. Dian＇hea was presented in 36% of patients, and autoimmune manifestations were presented in 36% of patients. Conclusions： GS is a rare association of thymoma and immunodeficiency with a poor prognosis. Astute clinical acumen and increased awareness of the clinical and immun
文摘目的探讨中医辨证治疗晚期结直肠癌化疗失败患者循环肿瘤DNA(ctDNA)状态、突变基因及其与预后相关性。方法收集83例晚期结直肠癌化疗失败患者外周血10ml,利用定制的覆盖416个肿瘤相关基因探针的Geneseeq One NGS面板进行杂交富集。高效捕获后进行聚合酶链式反应(PCR)扩增,在HiSeq NGS平台(Illumina)上对目标富集的文库进行测序。结果在纳入的83例经中医辨证治疗的晚期结直肠癌化疗失败患者中,有54例(65.06%)血浆中检测出肿瘤相关突变基因,共152个基因。根据突变频率筛选出APC、TP53、KRAS、PIK3CA等前20位的基因;ctDNA突变频率、肿瘤突变负荷(TMB)、KRAS、PIK3CA均与预后显著相关(P<0.05);临床相关因素分析显示,肝转移与多个肿瘤基因不良突变相关(P<0.05或P<0.01),脾肾两虚证与ctDNA突变频率、TMB、TP53相关(P<0.05),八纲辨证中阴证、阳证与TMB相关(P<0.05)。结论外周血ctDNA可以较好地反映中医辨证治疗的晚期结直肠癌化疗失败患者分子生物学状态,脾肾两虚证与较低的ctDNA突变频率、较低的抑癌基因突变存在相关性;阴证患者TMB较低,阳证患者TMB较高。
