Caspase-3/CPP32 immunoreactivity and its correlation with frequency of apoptotic bodies in human prostatic carcinomas and benign nodular hyperplasias

AIMS: Apoptosis is mediated by apoptosis-specific genes, certain oncogenes and tumour suppressor genes. Caspase-3, a group of cystein proteases, is involved in the induction of apoptosis and has been considered to correlate with apoptosis. The aim of this study was to determine whether caspase-3 is expressed in prostatic carcinoma and benign prostatic hyperplasia, and correlated with the apoptosis. METHODS AND RESULTS: We studied the apoptotic index and caspase-3 immunoreactivity in 40 cases of benign nodular hyperplasia (BPH) and 40 cases of prostate carcinoma (PCA) by in-situ labelling and immunohistochemistry. The mean number of apoptotic bodies in cases with BPH was not significantly different from cases with PCA I (Gleason score 2-4), but samples from patients with PCA II (Gleason score 5-7) and PCA III (Gleason score 8-10) showed a significantly higher apoptotic number than cases with BPH. Positive staining for caspase-3 was seen in 42.5% (17/40) of the BPH, and 27.5% (11/40) of the PCA: PCA I was 41.7% (5/12), PCA II 14.3% (2/14) and PCA III was 28.6% (4/14). CONCLUSIONS: Based on our results, the number of apoptotic bodies was not correlated with the caspase-3 expression and there was no relationship between caspase-3 expression and Gleason score. However, the number of apoptotic bodies was significantly higher in cases with intermediate (Gleason score 5-7) and high-grade (Gleason score 8-10) PCAs than cases with BPH and low-grade PCAs (Gleason score 2-4).     

The atopy patch test -- reproducibility and comparison of different evaluation methods

BACKGROUND: There is still a lack of standardization of the atopy patch test (APT) in test procedures and evaluation methods. Our aim was to examine the reproducibility of APT results and to compare visual evaluation to chromametry and laser Doppler imaging. METHODS: Fifty-two volunteers with atopic eczema/dermatitis syndrome (AEDS) were included. The APT was performed on tape-stripped and unstripped test fields on their backs using cat dander, house dust mite and grass pollen allergens from two different suppliers. Responders were re-tested 4-12 weeks later with the same allergens on their forearms. RESULTS: Using Allergopharma allergens, 14 (26.9%) volunteers showed one or more positive reactions. The reproducibility rate was 56.3%. The Erlangen atopy score in APT-positive and negative volunteers was 19 +/- 6 vs 15 +/- 6. The test agreement in volunteers tested with both allergens, from Allergopharma and Stallergènes, was poor. Correlation of the results between the three evaluation methods was significant (P < or = 0.001). CONCLUSIONS: The low reproducibility rate of APT results and the poor inter-test-agreement using allergens from different suppliers show that much work remains to make the APT a reliable tool in identifying relevant aeroallergens that lead to flare ups of AEDS. Compared to chromametry and laser Doppler imaging, visual scoring was superior in differentiation between irritative and allergic reactions.     

The use of a pretherapeutic, predictive score to determine inclusion criteria for the non-surgical treatment of ectopic pregnancy.

Non-surgical management of ectopic pregnancy has recently become an alternative to surgery. We have investigated a pretherapeutic score to define the indication for non-surgical and surgical treatment in 61 patients with ectopic pregnancy. The score was performed before the patients' inclusion in a nonsurgical management scheme. The score used six criteria which were evaluated on a scale from 1 to 3: gestational age, human chorionic gonadotrophin (HCG) level, progesterone level, abdominal pain, haemoperitoneum volume and haematosalpinx diameter (estimated by laparoscopy or transvaginal ultrasound). Three scores, 10, 11 and 12, were studied in order to define a threshold beyond which surgical treatment should be performed. For each one, sensitivity, specificity and positive and negative predictive values were analysed. The success rate of non-surgical treatment was 75% (46/61). For patients undergoing medical treatment with a score less than or equal to 12, the success rate was significantly higher compared with a success rate of 50% when the score was greater than 12. We conclude that a score less than or equal to 12 permits non-surgical management with a success rate of 82%. A score greater than 12 indicates that laparoscopic surgery may be more suitable. The choice between different non-surgical approaches, did not influence the success rate. When ultrasound reveals embryo heart activity, medical treatment is always possible if the score is less than or equal to 12.     

急性胰腺炎患者空腹高血糖发生率及其危险因素分析

目的:回顾性分析急性胰腺炎(AP)患者空腹高血糖发生率及其危险因素。方法:收集2018-01—2018-12武汉大学人民医院胰腺外科133例AP且无糖尿病(DM)病史的住院患者病历资料,按照不同性别、年龄、AP临床分型、病因、CT指数评分(CISI)等分组,χ2检验分析各组临床因素与空腹高血糖(FPG≥6.1mmol/L)发生率的关系,多因素二元logistic回归分析空腹高血糖独立危险因素。结果:AP临床分型(χ2=5.494,P=0.019)和CTSI(χ2=6.236,P=0.013)与AP患者空腹高血糖相关(P<0.05)。CTSI≥6分(P=0.015,OR=2.920,95%Cl=1.234—6.905)为AP患者空腹高血糖的独立危险因素(P<0.05)。结论:临床分型中重症+重症及CTSI≥6分的AP患者易发生空腹高血糖,尤其CTSI≥6分是AP后空腹高血糖的独立危险因素,临床应高度关注。     

Lack of PTEN expression in endometrial intraepithelial neoplasia is correlated with cancer progression

We tested the hypothesis that PTEN inactivation may stratify cancer progression risk among putative endometrial hyperplasias, classified prognostically by means of the morphometric D score (DS). The DS, calculated from 3 morphometric variables measured in routine hematoxylin-eosin-stained endometrial biopsy slides, is the most sensitive and specific method of endometrial cancer risk prediction currently available. Clinical outcomes of 103 women with endometrial hyperplasia on biopsy were tallied according to the DS. Seven (7/103; 7%) patients with carcinoma during follow-up were all distributed within the high-risk prognostic group (ie, DS <1 = endometrial intraepithelial neoplasia [EIN]) (7/21; 33% progression). None of the 82 cases with a DS higher than 1 progressed. All cases that progressed were PTEN null, indicating that this genotype is capable of further stratifying cancer progression risk in hyperplasias irrespective of histological categorization. However, only 16% of the PTEN-null cases progressed. When PTEN expression pattern was combined with EIN, the prognostic power was greatly increased (specificity from 63% for PTEN and 85% for EIN to 93% when combined; positive predictive value from 16% and 33% to 50%). We conclude that loss of PTEN expression is the first biomarker in EIN that increases the accuracy of the prognostic DS to predict cancer progression risk. Unless endometrial hyperplasias are stratified by histological morphometric D-Score, PTEN has a low positive predictive value.     

云南省1999-2003年围产儿出生缺陷监测结果分析

目的为了解云南省围产儿出生缺陷的发生种类及分布情况,寻找影响出生缺陷的相关因素.方法 1999年1月-2003年12月监测云南省多所医院住院分娩孕28w-产后7d的围产儿.按全国出生缺陷统一标准要求,由医院逐季上报<围产儿数季报表>,<出生缺陷登记卡>至省妇幼保健院.结果围产儿出生缺陷率为10.26‰(1013/98690),指(趾)畸形;唇腭裂;神经管畸形是云南省围产儿出生缺陷前3位高发种类,男性出生缺陷发生率为10.84‰(561/51732)高于女性9.41‰(442/46958),城市高于乡村,产妇年龄≥35岁是出生缺陷的高发风险因素.结论进一步开展婚前生殖健康教育和医学检查,指导新婚妇女服用小剂量叶酸预防神经管畸形,加强全民健康教育,提高环境意识,做好婚前保健,优生和孕产期保健,开展产前筛查或产前诊断是减少出生缺陷发生的有力措施.     

动态脑电图对缺血缺氧性昏迷病人的预后评估

目的：观察动态脑电图和临床检测指标对缺血缺氧性昏迷病人预后的评估价值。方法：在45例缺血缺氧性昏迷病人急性期进行动态脑电图检测和Glasgow评分、瞳孔对光反应、脑干反应检查，随访3个月时病人的预后，将动态脑电图检测和各项临床检查结果与病人的预后结果进行相关分析。结果：动态脑电图对昏迷病人预后的评估在敏感性(83．3％)、特异性(100％)和对预后评估的准确率(91．7％)方面均比临床检测结果高，临床指标Glasgow评分、瞳孔对光反射、脑干反射的敏感性、特异性及准确率分别为73．1％、84．2％及77．9％；76.9％、73．7％及75．6％；76．0％、68.4％及68．9％。结论：动态脑电图检测对急性缺血缺氧性昏迷病人预后的评估有确定的价值。     

神经症患者与正常人骨密度对照研究

目的探讨神经症患者骨密度情况.方法选择住院神经症患者60例为研究组;正常人60名为对照组.采用SPA-4系列骨矿分析仪,分别测量患者和正常人的骨线密度（BMC）和骨面密度（BMC/BW）,测量部位为右前臂桡骨中下1/3交界处.结果神经症患者的骨密度值BMC和BMC/BW均显著低于正常人（P〈0.01）.可能原因有：患者运动时间少,吸烟量高于正常人,与神经内分泌和免疫功能有关.结论神经症患者的骨密度低于正常人.     

Evolution of sleep and sleep EEG after hemispheric stroke

The evolution of subjective sleep and sleep electroencephalogram (EEG) after hemispheric stroke have been rarely studied and the relationship of sleep variables to stroke outcome is essentially unknown. We studied 27 patients with first hemispheric ischaemic stroke and no sleep apnoea in the acute (1-8 days), subacute (9-35 days), and chronic phase (5-24 months) after stroke. Clinical assessment included estimated sleep time per 24 h (EST) and Epworth sleepiness score (ESS) before stroke, as well as EST, ESS and clinical outcome after stroke. Sleep EEG data from stroke patients were compared with data from 11 hospitalized controls and published norms. Changes in EST (>2 h, 38% of patients) and ESS (>3 points, 26%) were frequent but correlated poorly with sleep EEG changes. In the chronic phase no significant differences in sleep EEG between controls and patients were found. High sleep efficiency and low wakefulness after sleep onset in the acute phase were associated with a good long-term outcome. These two sleep EEG variables improved significantly from the acute to the subacute and chronic phase. In conclusion, hemispheric strokes can cause insomnia, hypersomnia or changes in sleep needs but only rarely persisting sleep EEG abnormalities. High sleep EEG continuity in the acute phase of stroke heralds a good clinical outcome.     

The cumulative embryo score: a predictive embryo scoring technique to select the optimal number of embryos to transfer in an in-vitro fertilization and embryo transfer programme.

In order to achieve a clinical pregnancy rate higher than that achieved following initial adoption of in-vitro fertilization embryo transfers, more than one embryo is transferred. This has led to a substantial increase in unwanted multiple pregnancy rates with IVF as compared with natural conception. What is therefore required is a simple, clinically useful embryo scoring system, to reflect embryo developmental potential, which will enable the selection of the optimal number of embryos to transfer in order to achieve the maximum pregnancy rate with a low incidence of high order multiple pregnancies. We believe that the Cumulative Embryo Score (CES) achieves these aims. On the day of embryo transfer the grade of each embryo transferred was multiplied by the number of blastomeres to produce a score for each embryo, and summation of the scores obtained for all the embryos transferred gave the CES. The grouped pregnancy rates obtained rose as the CES increased to maximum of 42. A continued increase in the CES above 42 did not result in any further rise in the pregnancy rate. However, an analysis of all our IVF pregnancies showed that the multiple pregnancy rate continued to rise above a CES of 42. By restricting the CES per embryo transfer to 42, 78% of triplet pregnancies and 100% of the quadruplet IVF pregnancies could have been predicted and potentially avoided.