Neuropeptide S receptor gene (NPSR) and life events: G × E effects on anxiety sensitivity and its subdimensions

Objectives. The pathogenesis of anxiety is assumed to be interactively influenced by genetic and environmental factors. Thus, a gene–environment interaction (G × E) study of the neuropeptide S receptor gene (NPSR) A/T polymorphism (rs324981) and life events was conducted with respect to anxiety sensitivity (AS) as an intermediate phenotype of anxiety disorders. Methods. A sample of 475 healthy German subjects was genotyped for NPSR and assessed for AS, childhood maltreatment (CTQ) and recent life events (LTE). Influences on AS and its subdimensions were determined by a step-wise hierarchical regression and a multiple indicator multiple cause (MIMIC) model. Results. Significant main effects of NPSR and CTQ as well as significant G × E were observed, with T/T homozygosity and a high CTQ score resulting in increased anxiety sensitivity. MIMIC modelling yielded association of AS subfactor “concern about mental/cognitive incapacitation” and the basal somatic subdimension “concern about physical sensations” to be associated with CTQ and its interaction with NPSR, while the acute somatic subfactor “concern about heart/lung failure” was associated with NPSR and its interaction with LTE. Conclusions. Results indicate G × E effects of the more active NPSR rs324981 T allele and life events on AS with differential effects of temporally proximal and distal factors on specific AS subdimensions.     

Evaluation of the predictive role of neutrophil/lymphocyte ratio in the diagnosis of lymphoma in patients with asymptomatic and ısolated cervical lymphadenopathy

IntroductionThe diagnostic approach to patients with isolated asymptomatic cervical lymphadenopathy varies between excisional biopsy and follow-up. When the anamnesis, physical examination, laboratory and imaging findings are not sufficient to identify the etiology, an excisional biopsy is performed for the differential diagnosis between early-stage lymphoma and infectious or reactive causes. If the excisional biopsy, which may have some complications, is not performed, it may delay the diagnosis of lymphoma. This diagnostic challenge could be avoided by predictive markers.ObjectivesThis study was planned to determine the predictive value of neutrophil/lymphocyte ratio in the diagnosis of Hodgkin and non-Hodgkin limphoma in patients with asymptomatic, isolated cervical limphadenopathy and underwent excisional biopsy.MethodsA total of 90 patients between the years 2016 ? 2019 admitted to our clinics due to asymptomatic isolated cervical lymphadenopathy, present in at least 4 weeks with lympho nodes in pathological dimensions persisting in the cervical region, were included to our study. An excisional lympho node biopsy was performed in all 90 patients.ResultsOf the 90 patients who underwent excisional biopsy; 34 were diagnosed as reactive lymphadenopathy 30 were non-Hodgkin linphoma, and 26 were Hodgkin linphoma. A total of 56 (62.2%) patients were diagnosed as lymphoma, either Hodgkin or non-Hodgkin, while 34 patients (38.8%) were diagnosed as reactive lymphadenopathy. The median age, total whiteblood count, neutrophil count of the lymphoma groups were significantly higher than reactive lymphadenopathy group, whereas the lymphocyte count was significantly lower in the lymphoma patients. The median neutrophil/ lymphocyte ratio was 1.7 in the reactive lymphadenopathy group, 3.5 in the non-Hodgkin limphoma group, and 3.0 in the Hodgkin limphoma group (p <  0.001).ConclusionAccording to the results of our study, neutrophil/lymphocyte ratio was significantly higher in patients who were admitted with isolated asymptomatic lymphadenopathy and were diagnosed with lymphoma, and who were diagnosed with early-stage Hodgkin and non- Hodgkin lymphoma compared to those who were found to have reactive lymphadenopathy. Neutrophil/lymphocyte ratio, which is a low-cost, fast and easy-to-access test, has a predictive value in the diagnosis of lymphoma in patients with asymptomatic lymphadenopathy.     

Chronic rhinosinusitis and progression of cognitive impairment in dementia

AimThe relationship between chronic inflammatory disease and cognitive decline is still unclear, but there is increasing evidence to support the role of systemic inflammation. The aim of this study was to investigate if chronic rhinosinusitis (CRS) in dementia or mild cognitive impairment (MCI) is associated with the progression of cognitive decline.Material and methodsWe retrospectively reviewed the data of patients who complained of memory impairment, and underwent brain magnetic resonance imaging (MRI) from January 2006 to April 2019. According to the Mini-Mental State Examination (MMSE) score, subjects (n = 661) were divided into three groups: dementia (≤ 17), MCI (18–23), and normal (≥ 24). CRS was defined as a total score of greater than or equal to 4 according to the Lund–Mackay scoring system using brain MRI. Multiple logistic regression analyses estimated adjusted odds ratio (aOR) for the association between CRS and dementia or MCI. Among the subjects with follow-up MMSE (n = 286), a repeated-measures ANOVA was used to assess the difference of changes in MMSE scores between the groups with and without CRS.ResultsAccording to the initial MMSE score, there were 221 subjects with dementia, 195 with MCI, and 245 with normal results. CRS was not significantly associated with dementia (aOR = 1.519, CI = 0.909–2.538, P = 0.111), while being suggestively associated with MCI (aOR = 1.740, CI = 1.041–2.906, P = 0.034). The MMSE scores at follow-up decreased further in subjects with CRS than in those without CRS (P = 0.009). Especially, in the initial dementia group, there was a significant between-group difference in the MMSE score from baseline to follow-up (13.6 ± 4.3 to 11.1 ± 6.3 in CRS group vs. 13.5 ± 3.3 to 14.4 ± 5.4 in no CRS group, P = 0.002).ConclusionThe result of the present study implies a potential association between CRS and progression of cognitive decline. Physicians should be aware of this possibility in patients with clinically diagnosed CRS.     

HE4联合 CA125检测对卵巢良恶性肿瘤的诊断价值

目的：探讨人附睾上皮分泌蛋白4（HE4）对卵巢癌的诊断意义及其与糖链抗原CA125联合检测对卵巢良、恶性肿瘤的诊断价值。方法检测22例卵巢癌患者、46例卵巢良性肿瘤患者及35例健康女性血清中的HE4和CA125水平。 CA125的测定采用适用于96微孔反应板的时间分辨荧光测定仪测量,通过双抗体夹心时间分辨免疫荧光分析法进行测定。 HE4的测定应用电化学发光法进行测定。结果卵巢癌组HE4水平明显高于卵巢良性肿瘤和健康对照组,差异均具有统计学意义（t1＝3．356, t2＝3．865,均P＜0．05）;卵巢癌组血清CA125水平也高于卵巢良性肿瘤组和健康对照组,差异均有统计学意义（ t1＝4．656,t2＝5．126,均P＜0．05）。单独检测HE4的灵敏度和特异度分别为77．27％和84．78％;单独检测CA125的灵敏度和特异度分别为90．91％和80．43％;二者联合检测时灵敏度和特异度分别为72．73％和89．13％。结论 HE4对卵巢癌的诊断有较高的特异度;CA125的特异度低于HE4;HE4对卵巢癌的诊断价值优于单独CA125检测;联合检测提高了特异度,降低了的灵敏度。     

影响肺癌患者化疗后血常规与肝肾功能自我管理能力的因素分析

摘 要 目的：探讨影响肺癌患者化疗后血常规与肝肾功能自我管理能力的因素,为临床药师和医师对肺癌患者的指导和管理提供思路。 方法: 通过面对面交流和问卷调查两种方式对使用静脉化疗药物进行一线治疗的原发性支气管肺癌患者进行调查分析,调查项目包括年龄、性别、学历、经济情况、职业、居住区域、伴随的慢性疾病及用药、肿瘤类型及分期、体力状况 (PS) 评分等基本情况,以及是否定期复查、是否规律处理相应异常指标等依从性评价内容,分析影响患者化疗后血常规与肝肾功能自我管理能力的因素。 结果: 患者年龄、PS评分对患者的复查依从有明显影响 (P＜0.05),患者年龄对规范处理血常规与肝肾功能异常指标的意识有明显影响（P＜0.05）。经Logistics回归分析, 年龄、PS评分是影响肺癌化疗患者复查依从的独立风险因素,年龄是影响血常规与肝肾功能异常指标规范处理意识的独立风险因素（P＜0.05）。 结论: 药师有必要在患者每一周期入院化疗时均开展药学服务,尤其需强化年龄≥60岁的老年患者、PS评分为1的患者以及家属对血常规与肝肾功能规范管理的认识。     

聚山梨酯80对药品微生物限度检查的影响

目的：分析不同来源、不同浓度的聚山梨酯80对试验菌生长的影响,为聚山梨酯80在药品微生物限度检查中的应用提供参考。方法：取不同生产厂家、不同批号的聚山梨酯80,分别加入pH 7.0无菌氯化钠-蛋白胨缓冲液中,制备成3%、4%、5%、10%、15%、20%浓度(v/v)的溶液,作为供试液。按照中国药典2015年版四部通则1105和1106,进行需氧菌、霉菌和酵母菌计数方法适用性试验。同时进行控制菌大肠埃希菌、金黄色葡萄球菌和铜绿假单胞菌检查的方法适用性试验。结果：不同来源、不同浓度的聚山梨酯80对需氧菌计数和控制菌检查试验结果的影响差别较大,对霉菌和酵母菌计数试验结果影响差别不大。结论：不同来源、不同浓度的聚山梨酯80对试验菌的生长影响不同。药品微生物限度检查中使用聚山梨酯80时,需注意聚山梨酯80的来源不同对试验结果造成的差异。     

儿童肺炎支原体感染肺外损害166例分析

目的 了解儿童肺炎支原体(mycoplasma pneumoniae,MP)感染流行现状,分析并总结儿童肺炎支原体感染合并肺外损害的发病特点、临床表现、治疗方案及预后。方法 以被动凝集法检测安徽医科大学附属安庆医院2015年5月至2016年4月因下呼吸道感染住院儿童的血清MP抗体,对合并肺外损害的166例病儿的起病特点、临床表现、实验室检查等进行回顾性分析。结果 (1)1 329例病儿共检出支原体抗体阳性病儿369人,阳性率为27.8%。夏秋季节检出率更高,差异有统计学意义(χ2＝55.540, P＜0.05);(2)369例MP感梁病儿中出现肺外损害166例,阳性率为45.0%(166/369)。其中,年龄＜3岁组、3～6岁组、＞6岁组中肺外损害发生率分别为19.3%(32/166)、39.2%(65/166)、41.5%(69/166)。差异有统计学意义(χ2＝63.121,P＜0.05);(3)肺炎支原体可引起全身各脏器、系统肺外损害,以心血管系统最为常见(23.2%)。结论 (1)肺炎支原体感染可发生在任何年龄儿童,婴幼儿亦不少见。(2)不同季节肺炎支原体感染发生率不同,夏秋季节高发。(3)肺炎支原体感染可引起多系统肺外损害,其中以心血管系统损害更常见。(4)年龄＞3岁儿童更易发生肺外损害。