Significance of antineutrophil cytoplasmic antibody in adult patients with Henoch-Sch(o)nlein purpura presenting mainly with gastrointestinal symptoms

AIM: To test the clinical significance of antineutrophil cytoplasmic antibody (ANCA) in evaluation of adult Henoch-Schonlein purpura (HSP) patients presenting mainly with abdominal symptoms.METHODS: Twenty-eight consecutive HSP patients who presented predominantly with abdominal symptoms were enrolled in this study. Control subjects included 27 age-and sex-matched patients with peptic ulcer disease, colon cancer, acute gastroenteritis, irritable bowel syndrome and colonic polyps. ANCA was measured by indirect immunofluorescence (IIF) in all patients, and follow-up ELJSA was performed in patients with positive IIF tests.RESULTS: ANCA was detected in 9 HSP patients by IIF (2 were positive for c-ANCA and 7 were positive for p-ANCA). No ANCA was found in the control group. The sensitivity and specificity of a positive ANCA test (either c- or p-ANCA) were 32.1% and 100% respectively. Only one out of the 9 patients with positive ANCA by IIF had positive ANCA by ELISA and the antigen was myeloperoxidase (MPO). The patients positive for ANCA had higher HSP clinical scores, and were more likely to have renal function impairment. Patients with late purpura development were also associated with more severe clinical manifestations.CONCLUSION: A positive ANCA test is associated with more severe symptoms in HSP. After inflammatory bowel disease is excluded, a positive ANCA test provides a clue to the diagnosis of HSP presenting predominantly with abdominal symptoms.     

Multisite phosphotyping of the ErbB-2 oncoprotein in human breast cancer.

BACKGROUND: Overexpression of the ErbB-2 (HER2/neu) receptor tyrosine kinase is one of the most common molecular changes in human cancer, but the functional significance of this phenotype remains uncertain. METHODS AND RESULTS: Using phosphorylation-specific antibodies recognizing different ErbB-2 functional states, we assessed the phosphorylation status of ErbB-2 in 102 human breast cancer specimens. Quantitative ErbB-2 immunoblotting intensity correlated directly with that of immunohistochemistry (r = 0.84). Widely varying phosphorylation profiles were evident in 65 ErbB-2-positive carcinomas, suggesting different ErbB-2 functions in different tumors. In a subset of patients for whom clinical data were obtainable, mortality trends were strongly associated with the quantitative signal intensities of ErbB-2 phosphoantibodies (P < or =.02), but not with those of conventional antibodies to ErbB-2 (P = .147), epidermal growth factor receptor (P = .44), or phosphotyrosine (P = .94). CONCLUSION: Although requiring corroboration in larger prospective clinical studies, these findings suggest that immunophenotyping using phosphorylation-specific antibodies may enable more accurate prediction of cancer behavior than is currently obtainable using conventional reagents.     

Shy—Drager综合征12例临床分析

目的探讨Shy—Drager综合征的临床表现和影像学特点，以便早期诊断并改善患者预后。方法回顾性分析经临床诊断的12例Shy-Drager综合征患者的相关资料。结果Shy-Drager综合征患者临床以小便障碍、直立性低血压、性功能障碍、共济失调最常见。8例患者头颅磁共振检查结果示脑萎缩，主要为小脑和脑干萎缩。结论Shy—Drager综合征临床以自主神经功能障碍为主要表现，合并小脑症状发生率高，头颅磁共振可表现为小脑、脑干萎缩。     

The carboxyl-terminal domain of inducible Hsp70 protects from ischemic injury in vivo and in vitro.

Heat shock protein (Hsp)70 can suppress both necrosis and apoptosis induced by various injuries in vivo and in vitro. However, the relative importance of different functions and binding partners of Hsp70 in ischemic protection is unknown. To explore this question, we tested the ability of Hsp70-K71E, an adenosine triphosphate (ATP)ase-deficient point mutant, and Hsp70-381-640, a deletion mutant lacking the ATPase domain and encoding the carboxyl-terminal portion, to protect against ischemia-like injury in vivo and in vitro. Heat shock protein 70-wild type (-WT), -K71E, -381-640, and control vector plasmid LXSN were expressed in primary murine astrocyte cultures. Astrocytes overexpressing Hsp70-WT, -K71E, or -381-640 were all significantly protected from 4 h combined oxygen-glucose deprivation and 24 h reperfusion when assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay or propidium iodide staining and cell counting (P < 0.05). Brains of rats were transfected with plasmids encoding Hsp70-WT, -K71E, -381-640, or LXSN 24 h before 2 h middle cerebral artery occlusion followed by 24 h reperfusion. Animals that overexpressed either of the mutant proteins or Hsp70-WT had significantly better neurological scores and smaller infarcts than control animals. Protection by both mutants was associated with reduced protein aggregation, as assessed by ubiquitin immunohistochemistry and reduced nuclear translocation of apoptosis-inducing factor. The results show that the carboxyl-terminal portion of Hsp70 is sufficient for neuroprotection. This indicates that neither the ability to fold denatured proteins nor interactions with cochaperones or other proteins that bind the amino-terminal half of Hsp70 are essential to ischemic protection.     

术前经动脉灌注化疗对晚期乳腺癌细胞凋亡的影响

目的 :探讨术前动脉灌注化疗诱导乳腺癌细胞凋亡发生情况及其对患者预后的影响。方法 :分别采用TUNEL法检测及电镜观察术前动脉灌注化疗 40例和术前未化疗的 42例晚期乳腺癌细胞凋亡发生情况 ,计算凋亡发生率及凋亡指数 ,并进行对比分析。结果 :术前动脉灌注化疗组与术前未化疗组凋亡发生率分别为 92 5 %和 78 5 % ,凋亡指数分别为 19 37± 6 49和 9 2 6± 5 0 4(P <0 0 1)。凋亡指数高低与局部晚期乳腺癌的无病生存率相关 (P <0 0 1)。结论 :局部晚期乳腺癌术前动脉灌注化疗可诱导乳腺癌细胞的凋亡 ,提高患者无病生存率。     

PPH术联合倒“v”切口剥扎-皮瓣固定术治疗环状混合痔的临床观察(附50例报告)

目的 探讨观察PPH术联合倒"v"切口剥扎-皮瓣固定术的手术适应证、手术方法,提高微创手术的有效率及治愈率.方法 采用:①PPH术(吻合器痔上黏膜环切术)加倒"v"切口剥扎-皮瓣固定术联合应用治疗环状混合痔50例(治疗组)与外剥内扎术治疗环状混合痔50例(对照组)进行手术效果比较;②对两组病例平均住院时间、术后疼痛、术后出血、术后水肿、排便障碍、尿潴留、肛门潮湿等指标进行比较.结果 治疗组治疗效果明显优于对照组;术后肛门外观良好,无肛门狭窄、肛门失禁、精细控便障碍等后遗症,复发少.结论 PPH术联合倒"v"切口剥扎-皮瓣固定术治疗环状混合痔既不损伤肛门括约功能,又能保持良好肛门外观,临床效果肯定.     

Centralized isolation of Helicobacter pylori from multiple centers and transport condition influences

AIM:To evaluate the efficacy of centralized culture and possible influencing factors.METHODS:From January 2010 to July 2012,66452 patients with suspected Helicobacter pylori(H.pylori) infection from 26 hospitals in Zhejiang and Jiangsu Provinces in China underwent gastrointestinal endoscopy.Gastric mucosal biopsies were taken from the antrum for culture.These biopsies were transported under natural environmental temperature to the central laboratory in Hangzhou city and divided into three groups based on their transport time:5,24 and 48 h.The culture results were reported after 72 h and the positive culture rates were analyzed by a χ2 test.An additional 5736 biopsies from H.pylori-positive patients(5646 rapid urease test-positive and 90 14C-urease breath test-positive) were also cultured for quality control in the central laboratory setting.RESULTS:The positive culture rate was 31.66%(21036/66452) for the patient samples and 71.72%(4114/5736) for the H.pylori-positive quality control specimens.In the 5 h transport group,the positiveculture rate was 30.99%(3865/12471),and 32.84%(14960/45553) in the 24 h transport group.In contrast,the positive culture rate declined significantly in the 48 h transport group(26.25%; P 0.001).During transportation,the average natural temperature increased from 4.67 to 29.14℃,while the positive culture rate declined from 36.67%(1462/3987) to 24.12%(1799/7459).When the temperature exceeded 24℃,the positive culture rate decreased significantly,especially in the 48 h transport group(23.17%).CONCLUSION:Transportation of specimens within 24 h and below 24℃ is reasonable and acceptable for centralized culture of multicenter H.pylori samples.     

血清铁蛋白鉴别急性期皮肤黏膜淋巴结综合征与常见小儿急性发热性疾病

目的运用血清铁蛋白(SF)鉴别急性期皮肤黏膜淋巴结综合征与小儿常见急性发热性疾病。 方法选取2016年至2021年在苏州大学附属常州市肿瘤医院及南京医科大学附属常州第二人民医院就诊的皮肤黏膜淋巴结综合征患者185例，其中男性100例，女性85例；年龄1(1，2)岁。并同时选取其他小儿常见急性发热性疾病患者194例，其中男性99例，女性95例；年龄2(1，3)岁。疾病主要包含支气管肺炎，上呼吸道感染，幼儿急诊，疱疹性咽峡炎及化脓性扁桃体炎等。实验室检查测量白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LYM)、嗜酸性粒细胞计数(EO)、血红蛋白量(Hb)、血小板计数(PLT)、超敏C反应蛋白(超敏CRP)、C反应蛋白(CRP)、血沉(ESR)、总胆红素、总蛋白、白蛋白、谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)，降钙素原(PCT)、D-二聚体、N端脑钠肽前体(NT-proBNP)、SF、T细胞亚群(CD19、CD3、CD4、CD8)和NK细胞等血液学指标。 结果急性期皮肤黏膜淋巴结综合征患者WBC、NEUT、EO、PLT、超敏CRP、CRP、ESR、总胆红素、ALT、LDH、CK-MB，PCT、D-二聚体、NT-proBNP、SF、T细胞亚群(CD19、CD4、CD8)、CD4/CD8和NK细胞所测值显著高于其他小儿急性发热性疾病(P<0.01)，而Hb、总蛋白、白蛋白、AST、CK和CD3所测值显著低于其他小儿急性发热性疾病(P <0.01)。ROC曲线显示SF截点值为104.7 ng/mL时可以有效鉴别急性期皮肤黏膜淋巴结综合征与其他小儿急性发热性疾病，其诊断敏感度和特异度分别为92 %和52.94 %。 结论急性期皮肤黏膜淋巴结综合征患者SF较小儿急性发热性疾病明显升高；SF截点值为104.7 ng/mL时可以有效鉴别急性期皮肤黏膜淋巴结综合征与小儿急性发热性疾病。     

便携式在体机械灌注设备运行稳定性及保护无心跳供体器官的实验研究

目的探讨便携式在体机械灌注设备(IMPD)运行稳定性和保护无心跳大动物供器官的作用。 方法6只健康清洁巴马小型猪麻醉后开腹，分别经腹主动脉、下腔静脉插管并连接到自主研发的便携式IMPD，静脉注射氯化钾骤停心脏，观察5 min无复跳，启动设备对动物器官进行常温(37 ℃)机械灌注。调整离心泵转速和灌注流量以控制静脉血氧饱和度维持在60%～70%，持续灌注12 h，每2小时为观察时间点，记录设备管路流量、离心泵转速和流量/转速比值，检测肝、肾功能和血液内环境指标，灌注结束后获取胆总管、肝、肾和小肠组织，HE染色后光镜下评估病理改变情况。采用重复测量资料单因素方差分析比较灌注过程中各时间点运行参数、肝肾功能和血液内环境指标，组内两两比较采用LSD法，P<0.05为差异有统计学意义。 结果全部实验均完成12 h灌注，灌注过程中设备运行稳定，无故障或停机意外，管路流量、离心泵转速和流量/转速比值均稳定。ALT、总胆红素(TBIL)和谷氨酰转移酶(GGT)稳定，灌注开始至结束各时间点与术前相比，差异均无统计学意义(P均>0.05)。灌注开始后AST缓慢上升，灌注第8、10和12小时AST分别为(73±21)、(90±30)和(114±48)(U/L)，与术前相比，差异均有统计学意义(P均<0.05)。在实验猪心脏停跳的5 min内，乳酸在灌注开始时便处于峰值，自灌注第8小时起，乳酸数值与峰值相比差异均有统计学意义(P均<0.05)。K^＋浓度水平自灌注第2小时起各时间点与灌注开始时相比，差异均有统计学意义(P均<0.05)。ALT、TBIL、GGT、血尿素氮、血清肌酐、血气分析指标、Na^＋、Ca^2＋和Cl^-浓度水平稳定，灌注开始至结束各时间点数值与灌注开始时相比，差异均无统计学意义(P均>0.05)。自灌注开始后持续有胆汁生成、尿量产生。供肝灌注12 h的过程中，肝脏始终保持外观红润、质地柔软、边缘锐利。灌注结束后，胆总管、肝、肾和小肠组织病理结果示组织结构完整，无淤血和大面积坏死征象。 结论便携式IMPD可以稳定灌注无心跳猪供器官12 h，可以较好维护胆总管、肝、肾和小肠器官。