Sentinel lymph node biopsy for 102 patients with primary cutaneous melanoma at a single Japanese institute

Sentinel lymph node biopsy (SLNB) is a widely accepted standard procedure for patients with clinically localized melanoma. Melanoma prevalence and Clark's subtype differ between Asians and Caucasians. Here, we evaluated our experience on SLNB for cutaneous melanoma in a Japanese population. SLNB was performed for patients with melanoma between July 2000 and June 2014. We retrospectively analyzed 102 patients regarding association of clinicopathological features with sentinel lymph node (SLN) status, melanoma‐specific survival (MSS) and disease‐free survival (DFS). A positive SLN was significantly associated with primary Breslow thickness. Compared with 43 patients with negative SLN, 59 patients with positive SLN had significantly shorter MSS (5‐year survival rate, 94.3% vs 63.2%; P = 0.0002) and DFS (5‐year survival rate, 92.7% vs 63.4%; P = 0.0004). According to our subgroup analyses, nine patients with positive non‐SLN had significantly shorter MSS compared with 32 patients with negative non‐SLN (5‐year survival rate, 32.4% vs 68.5%; P = 0.0273). The survival of 51 Japanese patients with acral lentiginous melanoma (ALM) was not inferior to the survival of patients with other Clark's subtype. Breslow thickness is an important factor for both MSS and DFS, and the status of SLN is the most predictive prognostic factor in Japanese patients with clinically localized melanomas, as in case of Caucasians. Features of ALM may be different between Asians and Caucasians.     

Cdk13表达对神经元轴突伸长的影响

目的探讨智力障碍相关基因Cdk13对神经轴突伸长的影响。方法通过基因敲除模型、质粒细胞转染等方法,荧光共聚焦显微镜成像技术检测神经元轴突的形态,观察轴突伸长的变化。结果 Cdk12和Cdk13在神经系统中有表达,在敲除Cdk12和Cdk13后轴突长度比对照组减少,两者比较有统计学差异(P0.05),敲除Cdk12和Cdk13基因后Cdk5 mRNA水平降低。结论 Cdk13和Cdk12的表达对神经元轴突的生长至关重要,其失活会引起神经元轴突形态异常,可能是导致智力障碍的病理机制。     

Reviving through human hippocampal newborn neurons

Recent contradictory data has renewed discussion regarding the existence of adult hippocampal neurogenesis (AHN) in humans, i.e., the continued production of new neurons in the brain after birth. The present review revisits the debate of AHN in humans from a historical point of view in the face of contradictory evidence, analyzing the methods employed to investigate this phenomenon. Thus, to date, of the 57 studies performed in humans that we reviewed, 84% (48) concluded in favor of the presence of newborn neurons in the human adult hippocampus. Besides quality of the tissue (such as postmortem intervals below 26 hours as well as tissue conservation and fixation), considerations for assessing and quantify AHN in the human brain require the use of stereology and toxicological analyses of clinical data of the patient.     

长春西部地区1258例过敏原特异性IgE检测结果分析

目的了解长春西部地区过敏原特异性IgE分布情况。方法应用免疫印迹法检测1 258例患者的19种吸入性及食物性过敏原特异性IgE抗体,统计过敏原结果及种类。结果 1 258例患者,检出至少一种特异性IgE阳性率为34.0%。男性阳性率为33.5%;女性阳性率为34.5%。男女间阳性率差异无统计学意义(P> 0.05)。吸入性过敏原阳性率由高到低依次为:普通豚草14.2%、艾蒿11.4%、屋尘螨/粉尘螨8.1%、猫毛3.8%、狗上皮2.4%、柳树/杨树/榆树2.1%,屋尘1.6%、蟑螂1.6%、点青霉/分枝孢霉/烟曲霉/交链孢霉1.2%、葎草1.1%。食物性过敏原阳性率由高到低依次为:鸡蛋白2.9%、鳕鱼/龙虾/扇贝2.7%、牛奶2.3%、黄豆1.9%、蟹1.5%、虾1.3%、牛肉1.2%、花生1.0%、羊肉0.8%。混合过敏达到了相当高的比例。结论长春西部地区吸入性过敏原以普通豚草、艾蒿和屋尘螨/粉尘螨为主;食物性过敏原以鸡蛋白、鳕鱼/龙虾/扇贝、牛奶为主,明确过敏原,对过敏性患者的预防和治疗有重大意义。     

Risk communication in a patient decision aid for radiotherapy in breast cancer: How to deal with uncertainty?

Background and aimPatient decision aids for oncological treatment options, provide information on the effect on recurrence rates and/or survival benefit, and on side-effects and/or burden of different treatment options. However, often uncertainty exists around the probability estimates for recurrence/survival and side-effects which is too relevant to be ignored. Evidence is lacking on the best way to communicate these uncertainties. The aim of this study is to develop a method to incorporate uncertainties in a patient decision aid for breast cancer patients to support their decision on radiotherapy.MethodsFirstly, qualitative interviews were held with patients and health care professionals. Secondly, in the development phase, thinking aloud sessions were organized with four patients and 12 health care professionals, individual and group-wise.ResultsConsensus was reached on a pictograph illustrating the whole range of uncertainty for local recurrence risks, in combination with textual explanation that a more exact personalized risk would be given by their own physician. The pictograph consisted of 100 female icons in a 10 x 10 array. Icons with a stepwise gradient color indicated the uncertainty margin. The prevalence and severity of possible side-effects were explained using verbal labels.ConclusionsWe developed a novel way of visualizing uncertainties in recurrence rates in a patient decision aid. The effect of this way of communicating risk uncertainty is currently being tested in the BRASA study (NCT03375801).     

WT1基因与急性髓系白血病的预后及主动特异性免疫治疗的研究进展

WT1基因位于人类染色体11p13，在80%的急性髓系白血病（acute myeloid leukemia，AML）患者中高表达，是AML预后不良的分子标志，可作为AML预后评估和微小残留病变（minimal residual disease，MRD）监测的有效指标。由于WT1在AML中均有异常高表达，故认为是一种AML抗原，可作为特异性免疫治疗的新靶点。一些小规模的临床试验证实以WT1为靶点的免疫治疗是有效的、安全的，这些免疫治疗可作为那些有高危复发风险及初始标准化疗失败的AML患者的辅助治疗。本文就近几年WT1与AML的预后及有关以WT1为靶点的主动特异性免疫治疗的研究进展予以综述。     

褪黑素和6-羟褪黑素保护神经细胞抗缺血再灌注损伤比较研究

目的研究褪黑素(Mel)和6-羟褪黑素(6-OHMel)神经保护作用及作用机理。方法体外培养N2a细胞,模拟缺血再灌注(OGSD),加入Mel和6-OHMel,检测以下指标:①细胞生存能力:MTT法、乳酸脱氢酶释放;②细胞凋亡分析:DNA片断化,细胞色素C,Caspase3活性;③活性氧(ROS)和线粒体跨膜电位。结果①Mel和6-OHMel都能减轻OGSD诱导的N2a细胞损伤,Mel的作用强于6-OHMel。②Mel和6-OHMel均能抑制细胞色素C释放,但6-OHMel强于Mel。③Mel和6-OHMel都能稳定线粒体跨膜电位,但Mel作用时间比6-OHMel长。④Mel和6-OHMel能清除ROS,6-OHMel表现为直接作用,Mel表现为间接作用。⑤Mel和6-OHMel均能抑制caspase3的活性,但是作用时间不同。6-OHMel表现在OGSD后12h,Mel在OGSD后24h。结论Mel和6-OHMel的神经保护作用与其抗氧化、稳定线粒体功能相关,Mel的作用机制更复杂。     

对血清蛋白白球比值参考范围的修改及其临床应用

目的探讨血清蛋白白球比值(A／G)的参考范围和A／G在计算过程中产生的误差对临床应用的影响。方法①选取健康查体人员统计其A／G参考范围；②从理论上分析A／G计算误差的存在。结果①以统计结果的2s置信区间作为A／G的参考范围是1.1～2.2；②A／G计算值的误差会远大于相应总蛋白和白蛋白的测定误差。结论A／G较合适的参考范围为1.1～2.2,并且在临床应用中仍可根据实际情况降低其范围的下限。