Background Bladder cancer (BLCA) is a common malignant tumor of urinary system with high morbidity and mortality. In recent years, immunotherapy plays a significant role in the treatment of BLCA. Tumor mutation burden (TMB) has been reported to be a powerful biomarker to predict tumor prognosis and efficacy of immunotherapy. Our study aimed to explore the relationship between TMB, prognosis and immune infiltration to excavate the key genes in BLCA. Methods Clinical information, somatic mutation and gene expression data of BLCA patients were downloaded from The Cancer Genome Atlas (TCGA) database. According to the calculated TMB scores, patients were divided into high and low TMB groups. Gene Set Enrichment Analysis (GSEA) was performed to screen significantly enriched pathways. Differentially expressed genes (DEGs) between the two groups were identified. Univariate cox analysis and Kaplan-Meier survival analysis were applied for screening key genes. Immune infiltration was performed for TMB groups and NTRK3. Results Higher TMB scores were related with poor survival in BLCA. After filtering, 36 DEGs were identified. NTRK3 had the highest hazard ratio and significant prognostic value. Co-expressed genes of NTRK3 were mainly involved in several pathways, including DNA replication, basal transcription factors, complement and coagulation cascades, and ribosome biogenesis in eukaryotes. There was a significant correlation among TMB scores, NTRK3 expression and immune infiltration. Conclusions Our results suggest that NTRK3 is a TMB-related prognostic biomarker, which lays the foundation for further research on the immunomodulatory effect of NTRK3 in BLCA.
Objective: To systematically evaluate the efficacy index and adverse reactions of dezocine in postoperative pain relief, provide statistical theoretical support for guiding clinical application. Methods: We extracted and analyzed multiple data of patients from the PubMed, Embase, The Cochrane Library and China National Knowledge Infrastructure (CNKI) for use in randomized controlled trials of various surgical postoperative pain relief. We used meta-analysis to study several measures of efficacy and safety of dezocine, including visual analogue score (VAS), Ramsay sedation score, mean arterial pressure (MAP), heart rate (HR), Pulse Oxygen Saturation (SpO2) and the incidence of adverse events(AEs). The material data were calculated and analyzed using Review Manager 5.3. Results: After exclusion of literature that did not meet the inclusion criteria, our analysis included 14 randomized controlled trials. The Mean Difference (MD) of VAS at 1 h/6 h/24h between the dezocine group and the placebo group was -1.37 (95% CI -2.07,-0.67, P=0.0001),-0.52 (95% CI -1.04,0.01, P=0.05),-0.10 (95% CI -0.39,0.20, P=0.52), respectively. The MD of Ramsay sedation score at 2h/8h was 1.21 (95% CI 0.67,1.75, P<0.0001) and -0.17 (95% CI -0.59,0.26, P=0.44). The MD of MAP at T0/T1/T2 was -0.28 (95% CI -2.46,1.89, P=0.80),-2.66 (95% CI -5.07,-0.25, P=0.03),-4.53 (95% CI -6.17,-2.89, P<0.00001). The MD of HR at T0/T1/T2 was -2.26(95% CI -4.32,-0.21, P=0.03),-3.58(95% CI -5.21,-1.96, P<0.0001),-3.75 (95% CI -11.55,4.04, P=0.35). The MD of SpO2 at T0/T1 was -0.90(95% CI -1.77,-0.03, P=0.04) and 0.36(95% CI 0.02,0.71, P=0.04).The odds ratio (OR) of AEs was 0.53(95% CI 0.39,0.71, P<0.0001). Conclusion: Dezocine shows appropriate anesthetic efficacy and fewer adverse effects, which can reduce postoperative pain effectively.
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