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Objective To explore the value of peripheral blood circulating DNA in predicting the efficacy and prognosis of immunotherapy for advanced non-small cell lung cancer. Method A retrospective study was conducted on 78 NSCLC patients who were admitted to the Respiratory and Critical Care Medicine Department of the First Affiliated Hospital of Hebei North University and were treated with tirelizumab for advanced driver gene negativity from January 2021 to December 2021. After 2 cycles of immunotherapy, the efficacy was evaluated according to the Solid Tumor Efficacy Evaluation Criteria (RECIST 1.1), including complete remission, partial remission, disease stability, and disease progression. CR and PR patients were defined as the experimental group (n = 48) Other patients were defined as the control group (n = 30), and the ctDNA levels in peripheral blood were measured before and after treatment in both groups. ROC curves were used to analyze the predictive value of periph eral blood ctDNA levels for achieving objective remission after immunotherapy.All patients were followed up and their progression free survival were calcutated.Using univariate and multivariate regression analysis identified the factors affecting the prognosis of patients after immunotherapy. Using Spearman correlation coefficient analyzed the correlation between ctDNA levels and PFS. Kalplan Meier survival curve were used for survival analysis. Result The peripheral blood ctDNA levels before and after treatment in the experimental group were (4.47 ± 1.21)ng/μL and (2.65 ± 1.14) ng/μL, respectively (t = 7.559,P < 0.001), while those in the control group were (4.54 ± 1.15)ng/mL and (4.29 ± 1.57) ng/μL, respectively (t = 0.699,P = 0.487). There was no statistically significant difference in peripheral blood ctDNA levels between the two groups before treatment (t = -0.25,P = 0.801). The peripheral blood ctDNA levels in the experimental group decreased compared to the control group after treatment (t = -5.35,P < 0.001). The ROC curve analysis showed that the area under the curve for predicting objective remission after immunotherapy based on peripheral blood ctDNA levels was 0.819, with a sensitivity of 81.3% and specificity of 80%. Peripheral blood ctDNA levels were negatively correlated with progression free survival (r = -0.784,P = 0.000). Single factor COX regression was used to analyze the clinical and pathological characteristics and ctDNA levels of enrolled patients, and the results showed that the maximum tumor diameter was greater than 5 cm (HR = 0.501, 95% CI: 6.731 ~ 35.567) Tumor stage IV (HR = 0.392,95% CI: 0.227 ~ 0.677), treatment approach (HR = 15.473,95% CI: 6.731 ~ 35.567), and ctDNA levels (HR = 4.657,95% CI: 3.182 ~ 6.555) are all influencing factors for PFS in advanced NSCLC patients after immunotherapy. Multiple factor analysis was conducted on the appeal indicators with statistical differences, and the results showed that treatment approach (HR = 2.981,95% CI:1.019 ~ 8.722) and peripheral blood ctDNA levels (HR = 3.918,95% CI: 2.619 ~ 5.861) It is an independent influencing factor of PFS in advanced NSCLC patients. The Kalplan Meier survival curve was used for analysis, and the results showed that the median PFS of the treatment effective group was 8.4 months, while the median PFS of the control group was 5.4 months. (χ² = 49.277, P = 0.000). Conclusion Immunotherapy combined with chemotherapy can enhance the ability to kill tumor cells, and peripheral blood ctDNA levels can evaluate the efficacy and prognosis of immunotherapy, which can be used to guide immunotherapy in advanced NSCLC patients. [ABSTRACT FROM AUTHOR]

Objective To observe the dynamic changes of free CD147 and its induced product matrix metalloproteinase-9 (MMP-9) of patients with traumatic brain injury (TBI) in peripheral blood, and to explore the relationship between its expression changes and short-term prognosis. Methods Thirty-nine patients with TBI admitted to the Second Hospital of Tianjin Medical University from May 2014 to December 2016 were included in the study. The expression changes of free CD147 and MMP - 9 in peripheral blood were determined by enzyme-linked immunosorbent assay (ELISA), and the activity of MMP-9 was determined through gelatin zymography. The prognosis was evaluated via Glasgow Outcome Scale (GOS) at discharge. Results There was no significant difference in GOS score between male and female patients at discharge (2.63 ± 1.28 vs. 2.57 ± 1.14; t = 0.161, P = 0.873). There was a statistically significant difference in GOS score between different age groups at discharge (t = 2.191, P = 0.038). The GOS scores of patients over 60 years old were lower than those of patients under 40 years old (t = 2.645, P = 0.014) and those between 40 and 60 years old (t = 2.320, P = 0.029). According to the GOS score, they were divided into a good prognosis group (GOS score ≥ 3, n = 25) and a poor prognosis group (GOS score < 3, n = 14). Free CD147 in peripheral blood of patients with poor prognosis [(5.07 ± 1.89) ng/ml vs. (10.37 ± 1.69) ng/ml; t = 2.080, P = 0.048] and MMP-9 [(41.55 ± 4.67) ng/ml vs. (75.23 ± 5.18) ng/ml; t = 2.512, P = 0.019] were higher than the good prognosis group. Correlation analysis showed that the GOS score at discharge was negatively correlated with free CD147 (r = - 0.473, P = 0.000) and MMP - 9 (r = - 0.435, P = 0.036) in peripheral blood. Conclusions The higher the level of free CD147 and its induced product MMP-9 in peripheral blood of patients with TBI, the worse the prognosis, which indicated that free CD147 and MMP-9 can be used as important indicators for poor prognosis of patients with TBI. [ABSTRACT FROM AUTHOR]

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Objective To investigate the cognitive change in electrical stimulation (ECS) pre-conditioned rats after traumatic brain injury (TBI) and the role of endothelial progenitor cells in brain trauma. Methods Adult male Wistar rats were divided into 4 groups randomly: Sham group (n = 61), TBI group (n = 61), ECS pre-conditioned and TBI group (ECS-TBI group, n = 61), ECS group (n = 61). At 3 h, 6 h, 24 h, 48 h, 72 h after fluid percussion injury (FPI), 6 rats were randomly selected from each group and the number of circulating endothelial progenitor cells was counted by flow cytometry. At the same time, 3 rats from each group were chosen randomly and brain tissue was taken out. Microvascular density (MVD) of injured hippocampus was measured by vWF immunohistochemical staining. Ten rats of each group were subjected to Morris Water Maze Test and escaping latencies were recorded separately at 7-11 days after FPI. Results Compared with TBI group, the number of endothelial progenitor cells in peripheral circulation increased significantly in ECS-TBI group at 3 hours and 6 hours after brain trauma (P = 0.000, for all), and reduced to baseline gradually afterwards. The vWF+ MVD on the injured side of hippocampus in ECS-TBI group was higher than those of other groups 1d after FPI, and reached to a peak at 7 d (P < 0.01). In Morris Water Maze Test, the escaping latency of ECS-TBI rats were reduced significantly compared to that of the TBI group from 3 d to 5 d after brain trauma (P < 0.01). Conclusion Compared to TBI group, there was less cognitive defect in ECS-TBI group after traumatic brain injury. This protective effect may partially due to enhanced angiogenesis induced by increasing circulating endothelial progenitor cells after ECS. Endothelial progenitor cells accumulated in the injured brain may promote post-traumatic angiogenesis and recovery of neurological function. DOI：10.3969/j.issn.1672-6731.2011.06.005