Microenvironment and related genes predict outcomes of patients with cervical cancer: evidence from TCGA and bioinformatic analysis

Cervical cancer (CESC) is one of the most common cancers and affects the female genital tract. Consistent HPV infection status has been determined to be a vital cause of tumorigenesis. HPV infection may induce changes to the immune system and limit the host’s immune response. Immunotherapy is therefore essential to improving the overall survival of both locally advanced and recurrent CESC patients. Using 304 relevant samples from TCGA, we assessed immune cell function in CESC patients to better understand the status of both tumor micro-environment cells and immune cells in CESC. Functional enrichment analysis, pathway enrichment analysis, and PPI network construction were performed to explore the differentially expressed genes (DEGs). The analysis identified 425 DEGs, which included 295 up-regulated genes and 130 down-regulated genes. We established that upregulation of CCL5 was correlated with significantly better survival, meaning that CCL5 expression could serve as a novel prognostic biomarker for CESC patients. We further focused on CCL5 as a hub gene in CESC, as it had significant correlations with increased numbers of several types of immune cells. Cell-type fractions of M1 macrophages were significantly higher in the high-immune-scores group, which was associated with better overall survival. Finally, we concluded that CCL5 is a promising prognostic biomarker for CESC, as well as a novel chemotherapeutic target.     

基于SPRINT分类算法进行医学预后分析的研究与应用

SPRINT算法是一种具有良好扩展性且能实现并行处理的数据分类方法,可以方便地从算法生成的决策树提取规则.在使用海量医学数据库进行预后分析中,它是值得推荐的一种研究方法.对该算法进行了深入研究,并在预后分析中进行了应用,对于类似医学信息处理有启发意义.     

基底动脉闭塞的DSA分析

目的探讨脑干梗死经DSA全脑血管造影证实基底动脉闭塞后的临床与预后,以期对临床治疗有一定的指导意义。方法选取14例在临床中发现并经脑血管造影证实为基底动脉闭塞而临床症状轻微的患者。分析基底动脉闭塞后的临床表现与侧支代偿之间的关系。结果(1)基底动脉近端闭塞,临床表现多以眩晕发作为主(占91%);中段或远端闭塞,则多表现为间断性意识障碍(占66.7%)。(2)基底动脉近端闭塞,侧支血流多由颈外动脉和锁骨下动脉分支及椎动脉颅外段的肌支或脊髓前动脉代偿供血;基底动脉中、远段闭塞,侧支血流多由小脑后下动脉与小脑上动脉吻合(占100%)。结论基底动脉闭塞若侧支代偿充分,可不表现明显的脑干缺血表现或表现轻微。内科治疗效果较好。     

A framework for effective management of condition based maintenance programs in the context of industrial development of E-Maintenance strategies

CBM (Condition Based Maintenance) solutions are increasingly present in industrial systems due to two main circumstances: rapid evolution, without precedents, in the capture and analysis of data and significant cost reduction of supporting technologies. CBM programs in industrial systems can become extremely complex, especially when considering the effective introduction of new capabilities provided by PHM (Prognostics and Health Management) and E-maintenance disciplines. In this scenario, any CBM solution involves the management of numerous technical aspects, that the maintenance manager needs to understand, in order to be implemented properly and effectively, according to the company’s strategy. This paper provides a comprehensive representation of the key components of a generic CBM solution, this is presented using a framework or supporting structure for an effective management of the CBM programs. The concept “symptom of failure”, its corresponding analysis techniques (introduced by ISO 13379-1 and linked with RCM/FMEA analysis), and other international standard for CBM open-software application development (for instance, ISO 13374 and OSA-CBM), are used in the paper for the development of the framework. An original template has been developed, adopting the formal structure of RCM analysis templates, to integrate the information of the PHM techniques used to capture the failure mode behaviour and to manage maintenance. Finally, a case study describes the framework using the referred template.     

<i>In Silico</i> analysis and linking of metabolism-related genes with the immune landscape in head and neck squamous cell carcinoma

Metabolic reprogramming and immunologic suppression are two critical characteristics promoting the progression of head and neck squamous cell carcinoma (HNSCC). The integrative analysis of all the metabolism-related genes (MRGs) in HNSCC is lacking and the interaction between the metabolism and the immune characteristics also requires more exploration to uncover the potential mechanisms. Therefore, this study was designed to establish a prognostic signature based on all the MRGs in HNSCC. Genes of HNSCC samples were available from the TCGA and GEO databases while the MRGs were retrieved from a previous study. Ultimately 4 prognostic MRGs were selected to construct a model possessing robust prognostic value and accuracy in TCGA cohorts. The favorable reproducibility of this model was confirmed in validation cohorts from GEO databases. The risk score calculated by this model was an independent prognostic factor that further classified these HNSCC patients into high-/low-risk groups. GSEA analyses and somatic mutations indicated the low-risk group could activate several anti-tumor pathways and possessed lower TP53 mutation. The results of ESTIMATE, single-sample GSEA, CIBERSORT, and some immune-related molecules analyses suggested the low-risk group exhibited lower metabolic activities and higher immune characteristics. The Spearman correlation test implied most metabolic pathways with tumor-promoting function were negatively correlated with the immune activity, indicating a plausible approach of combining the anti-metabolism and the immunotherapy drugs in the high-risk group to enhance therapeutic effects than applied separately. In conclusion, this prognostic signature linking MRGs with the immune landscape could promote the individualized treatment for HNSCC patients.     

高钠血症对颅脑损伤患者预后的影响

目的探讨各种颅脑损伤的患者病程中出现高钠血症后对其预后的影响。方法分析247例各种颅脑损伤患者的临床资料,记录血钠的测定值,治疗及预后的情况,并对所得数据进行统计学处理与分析。结果高钠血征的出现与疾病种类无关;高钠血症患者的死亡率明显高于正常血钠者;同时持续性高钠血征的纠正与否均不改善预后。结论持续性高钠血症的出现暗示着颅脑损伤病情的加重,预后不佳。     

早期CT环池形态变化与急性颅脑损伤病人预后关系的研究

目的前瞻性研究急性颅脑损伤患者早期CT扫描征象的环池形态和中脑变形程度与病人预后的关系,以指导临床的治疗。方法对132例病人早期CT扫描,在中脑水平准确测量环池宽度,分6个组记录数据。同时观测中脑有无变形及测量其前后径与横径之比。治疗后按GOS标准,随访3个月,评定疗效。结果通过比较,环池宽度>1mm者有较佳的预后;中脑无变形及前后径与横径之比为0.9∶1.1者的预后较佳。结论研究得出,环池形态、中脑受压变形能作为急性颅脑损伤患者预后判断的指标,并为临床医师治疗方案提供重要依据。     

Derivation of a clinical decision rule for whiplash associated disorders among individuals involved in rear-end collisions

A prospective study was used to: (1) quantify potential risk factors for whiplash associated disorder following a rear-end motor vehicle collision; and (2) develop a simple clinical decision rule for the early identification of patients at risk for long-term whiplash associated disorder. Between 1 October 1995 and 31 March 1998, 446 adults involved in rear-end collisions presented to the only two emergency departments serving Kingston, Ontario. Eligible and consenting subjects (n = 353) were contacted by telephone soon after the collisions then at multiple occasions up to 2 years post-collision. Bivariate and multiple logistic regression analyses were used to identify potential risk factors for persistent symptoms. A software package that uses Chi-squared automatic interaction detection and classification and regression trees was used to develop a simple clinical decision rule for the identification of patients at high and low risk for persistent whiplash associated disorder. Risk factors identified by regression analyses included: increased age, number of initial physical symptoms, and early development of the following symptoms: upper back pain, upper extremity numbness or weakness, or disturbances in vision. A simple clinical decision rule that requires asking up to three basic questions of each patient was derived and would have identified the 118 cases of persistent whiplash associated disorder with a sensitivity of 91.5% (95% confidence interval: 86.5, 96.6) and a specificity of 51.4% (44.7, 58.1). This study confirmed the importance of several risk factors for whiplash associated disorder following rear-end motor vehicle collisions.     

低Hb水平对AMI患者短期预后的影响

目的了解血红蛋白水平对急性心肌梗死(AMI)患者短期预后的影响。方法回顾性分析兰州大学第二医院1998年1月至2007年1月因AMI入院的临床资料,依据入院时患者血红蛋白水平分为二组:血红蛋白水平≤100g/L组195例,血红蛋白水平>100g/L组1256例,研究的主要终点是30d死亡率。结果二组患者30d总死亡率为11.7%,血红蛋白水平≤100g/L组有37例死亡(19.0%),其死亡率比血红蛋白水平>100g/L组明显增高(133例死亡,10.6%,P<0.001)。多元逻辑回归分析显示:当对其它因素校正后,低血红蛋白水平仍是30d死亡的独立预测因素(HR1.86,CI1.12～2.96;P=0.02)。结论低血红蛋白水平与急性心肌梗死30d死亡明显相关,可作为判断预后不良的指标,应考虑对这些患者采取特殊治疗策略。     

Degradation state model-based prognosis for proactively maintaining product performance

Maintenance plays now a critical role in manufacturing for achieving important cost-savings and competitive advantage while preserving product conditions. It suggests moving from conventional maintenance practices to predictive strategy. Indeed the maintenance action has to be done at the right time according the component Remaining Useful Live (RUL) assessed by a prognosis process. The accuracy of the RUL is mainly depending on the relevance of the component degradation model used for prediction. In that way, this paper aims at discussing an efficient degradation model taking into account the operational conditions, the health monitoring and the maintenance actions. This model is based on discrete states associated with the degradation levels, and on a cumulative function modelling the transition time between successive states. The model is implemented by means of Stochastic Activity Networks (SAN). The feasibility and added value of such degradation models for prognosis is then highlighted through experimentations made on manufacturing TELMA platform.