【摘要】 目的 分析合并免疫指標異常的視神經脊髓炎臨床特點。 方法 回顧性分析2009年5月-2010年11月收治的62例視神經脊髓炎患者中24例合并免疫指標異常患者的臨床資料。24例均為女性，發病年齡14~53歲。對其臨床表現、視覺誘發電位、影像學檢查結果、免疫檢查結果進行分析。 結果 所有患者均有脊髓和視神經同時或先后受累的表現。24例視覺誘發電位檢查23例異常。脊髓MRI顯示病變集中于頸段、上胸段脊髓。頸段和胸段脊髓同時受累17例，單純頸段脊髓受損6例，單純胸段脊髓受損1例。所有患者抗核抗體滴度均≥1∶100，合并抗SSA抗體陽性14例（55.5％），同時合并抗SSB抗體陽性11例（45.8％），合并抗Rib抗體陽性1例，合并抗SCL-70抗體陽性1例，合并抗dsDNA抗體1例。 結論 視神經脊髓炎合并免疫指標異常的患者以女性較為多見，易復發，青壯年患者發病率最高。脊髓MRI示病變集中于頸段、上胸段脊髓，表現為長節段脊髓損害。視神經脊髓炎患者合并結締組織病的病例較多。【Abstract】 Objective To analyze the clinical features of neuromyelitis optica (NMO) combined with abnormal immune parameters. Methods We retrospectively reviewed the clinical data of 24 patients with NMO and abnormal immune parameters among the 62 NMO patients who were admitted into our department between May 2009 and November 2010. All patients were female, aged from 14 to 53 years. We analyzed their clinical manifestations, visual evoked potentials, imaging results, and immunological examinations. Results All patients had simultaneous or successive spinal cord and optic nerve involvement. Twenty-three patients had abnormal visual evoked potential. MRI showed that the lesions focused on the cervical and upper thoracic spinal cord. Both cervical and thoracic spinal cord were involved in 17 cases; there were 6 cases of simple cervical spinal cord injury and 1 case of simple thoracic spinal cord damage. Antinuclear antibody titer of all the patients was ≥1∶100. Combined positive anti-SSA antibody occurred in 14 patients (55.5%); Concomitant positive anti-SSB antibodies occurred in 11 patients (45.8%); Combined positive anti-Rib antibodies occurred in 1 patient; Combined positive anti-SCL-70 antibody occurred in 1 patient; and combined positive anti-dsDNA antibodies occurred in 1 patient. Conclusions NMO combined with abnormal immune parameters mainly occurs in female patients, especially in young people. Recurrence rate is high. MRI shows that the lesions focus mainly on the cervical and upper thoracic spinal cord, manifesting the characteristic of long segment damage. And NMO is frequently combined with connective tissue disease.
ObjectiveTo systematically investigate the functional roles of the nucleotide metabolism-related gene ecto-5'-nucleotidase (NT5E) in lung adenocarcinoma (LUAD) and to provide potential molecular targets for precision diagnosis and targeted therapy. MethodsMulti-omics analyses were performed using transcriptomic data from The Cancer Genome Atlas (TCGA) and gene expression omnibus (GEO) to identify key prognostic genes and to construct a prognostic model. Tumor tissue specimens from patients with LUAD who underwent surgical resection at the Qingdao Central Hospital of University of Health and Rehabilitation Sciences between May and June 2023 were collected for prognostic gene validation, and tissue microarrays were constructed to evaluate protein expression. In vitro, the biological effects of NT5E on LUAD cells were validated by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR), Western blotting, wound-healing, Transwell, EdU, cell-cycle, and apoptosis assays. ResultsA total of 10 paired tumor and adjacent non-tumor tissue samples were used for validation of key prognostic genes, including 4 male and 6 female patients, with a mean age of (58.00±13.06) years. In addition, tissue microarrays comprising 90 patients were analyzed, including 28 male and 62 female patients, with a mean age of (60.07±7.98) years. Bioinformatic screening identified NT5E as a representative prognostic gene that was significantly upregulated in LUAD tissues. Survival analyses demonstrated that high NT5E expression was associated with markedly poorer overall survival and served as an independent risk factor. qRT-PCR and tissue microarray-based immunohistochemistry further confirmed its elevated expression in tumor tissues. Functional experiments showed that NT5E knockdown significantly inhibited cell migration, invasion, and proliferation while promoting apoptosis, whereas NT5E overexpression exerted the opposite effects. ConclusionNT5E markedly promotes LUAD cell proliferation, migration, and invasion and suppresses apoptosis, indicating that NT5E acts as an oncogenic driver in LUAD and may serve as a promising prognostic biomarker and therapeutic target.