Sporadic extra abdominal wall desmoid-type fibromatosis: Surgical resection can be safely limited to a minority of patients

BackgroundTo analyse the natural history of extra-abdominal wall desmoid-type fibromatosis (DF) and compare outcome in patients who underwent initial surgery with those who did not.Patients and methodsAll consecutive patients affected by primary sporadic extra-abdominal wall DF observed between January 1992 and December 2012 were included. Patients were divided into surgical (SG) or non-surgical groups (NSG) according to initial treatment. Relapse free survival was calculated for SG, and crude cumulative incidence (CCI) of switching to surgery or other treatments for NSG.Results216 patients were identified, 94 in SG (43%), 122 in NSG (57%). A shift towards a more systematic use of a conservative approach (78% of all comers) was observed in the latter years (2006–2012), although a small proportion of patients (28%) had been offered the conservative strategy even in the early period (1992–2005). Median follow-up (FU) was 49 mo. (interquartile (IQ), 20–89 mo.), 76 months for SG and 39 months for NSG. 5-year relapse-free survival (RFS) for SG was 80% (95% confidence interval (CI), 72–89%). For the NSG, 5-year CCI of switching to surgery was 5% (95% CI: 1.7%, 14%), and 51% to other treatments (95% CI: 41%, 65%). 27 (20%) NSG patients underwent spontaneous regression.ConclusionA non-surgical approach to extra-abdominal wall DF allowed surgery to be avoided in the majority of patients. This approach can be safely proposed and surgery offered as an option in selected cases.     

降钙素原、血小板及D-二聚体检测在脓毒症预后中的价值

目的:探讨脓毒症病人血清降钙素原、血小板及D-二聚体等指标在脓毒症病人预后中的价值。方法:选取脓毒症病人45例,其中非脓毒性休克组25例,脓毒性休克组20例,另选择同期住院的非脓毒症病人25例作为对照组。病人入院24～48h内完成降钙素原、血小板及D-二聚体水平的检测,并进行相关数据分析。结果:脓毒症组降钙素原及D-二聚体水平均高于对照组,血小板水平低于对照组（P<0.01）。脓毒性休克组降钙素原及D-二聚体水平高于非脓毒性休克组,血小板水平低于非脓毒性休克组（P<0.01）。脓毒症组三项指标与预后明显相关,预后良好组降钙素原及D-二聚体低于预后不良组,血小板高于预后不良组（P<0.01）。相关分析显示,脓毒症组降钙素原与SOFA评分、APACHEⅡ评分呈显著正相关关系,血小板与二者呈显著负相关关系。结论:降钙素原、血小板及D-二聚体水平可作为脓毒症严重程度评价及预后预测的指标。     

TRAIL facilitates cytokine expression and macrophage migration during hypoxia/reoxygenation via ER stress-dependent NF-κB pathway

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), which is known as a key molecule to induce cancer cell apoptosis, has also been found to participate in the process of ischemia/reperfusion (I/R) injury. Infiltrated macrophages play dual roles in inflammatory injury and healing following I/R. Whether TRAIL has any effect on macrophages during this process remains elusive. Here we showed that I/R triggered the expressions of TRAIL, DR5 and cytokines (IL-1β, TNFα, CCL-2 and ICAM-1), in addition to macrophage infiltration, which could be abolished by TRAIL neutralizing antibody. In vitro, TRAIL enhanced DR5 expression and facilitated the macrophages migration following hypoxia/reoxygenation (H/R) treatment in a dose-dependent manner via ER stress and NF-κB signaling pathways, which is accompanied by inflammatory factors expression. The increased cytokines production (such as TNFα and IL-1β) stimulated by TRAIL can be blocked by the NF-κB and ER stress inhibitor. The results also suggested that NF-κB activation of macrophages during H/R was regulated by ER stress. Thus, our research present that TRAIL affects functional activities of macrophages during I/R injury, which may be a potential therapeutic target for ischemic heart disease.     

Comparison of commercial influenza A virus assays in detecting avian influenza H7N9 among poultry cloacal swabs,China

BackgroundAvian H7N9 virus emerged in China in February 2013 and has since spread widely among China's poultry, causing numerous human infections.ObjectivesTo compare World Health Organization (WHO) and US commercial influenza assays in detecting avian H7N9 virus in poultry cloacal specimens.Study designBetween April 6 and July 15, 2013, 261 cloacal swabs were collected from commercial poultry in Nanjing and Wuxi City, Jiangsu Province, China. Swabs were screened with the WHO's influenza A and H7N9 real-time RT-PCR (qRT-PCR) assays. A blinded panel of 97 specimens (27 H7N9-positive and 70 influenza A-negative) was then used to compare 3 antigen based commercial assays (Remel Xpect Flu A&B, Quidel Quickvue influenza, and Quidel Sofia Influenza A + B), and 2 molecular commercial assays (Quidel Molecular Influenza A + B assay and Life Technologies VetMAX™-Gold SIV Detection Kit). None of these commercial assays were approved for use with poultry specimens.ResultsConsidering the WHO H7N9 qRT-PCR assay as the gold standard, all assays except the Quidel Quickvue influenza assay had high specificity (ranging from 96 to 99%). Regarding sensitivity, the Life Technologies VetMAX™-Gold SIV Detection Kit (100%; 95% CI 87–100%) and the Quidel Molecular Influenza A + B assay (85%; 95% CI 66–96%) performed the best. The sensitivities of the non-molecular antigen detection assays were either unable to detect small amounts of H7N9 viral RNA or were inhibited by specimen type.ConclusionsThe Life Technologies VetMAX™-Gold SIV Detection Kit and the Quidel Molecular Influenza A + B assay are comparable in performance to the WHO H7N9 qRT-PCR assay in detecting H7N9 from poultry cloacal specimens.     

VEGF-A loss in the haematopoietic and endothelial lineages exacerbates age-induced renal changes

Renal function declines with age and this is more pronounced in males than females. VEGF-A is essential for glomerular development and function but its role in other aspects of renal function is poorly understood. We therefore investigated the role of VEGF-A, derived specifically from haematopoietic and endothelial lineages in the kidney. We crossed VavCre and floxed Vegf-a mice allowing specific ablation of a single Vegf-a allele in the haematopoietic and endothelial lineages. Mutants were viable and fertile and had normal haematological composition, indicating that 50% gene dosage of Vegf-a in the Vav-expressing lineage is sufficient for establishing a functional haematopoietic system and mature vascular network. However, several abnormalities were observed in the kidney of the adult mutants. These included the formation of inclusion bodies in the proximal tubular cells, tubular atrophy and interstitial fibrosis. These features were observed in 9–11 month-old mutant animals. Most of these abnormalities have been described in aging kidneys in man, and were also observed in the older control mice (24 months). The pathological features appeared in mutant male animals at a younger age than in female mutants. This indicates that reduction in Vegf-a gene dosage in haematopoietic and endothelial lineages accelerates renal aging, suggesting that VEGF-A derived from these lineages may play a role in protecting the kidney from age-associated damage.     

GC直接进样与顶空进样法检测睾酮衍生物AD残留量

建立毛细管气相色谱法,分别采用溶液直接进样与顶空进样法测定睾酮衍生物AD中溴代环戊烷的残留量。溶液直接进样法:色谱柱为DB-WAX石英毛细管柱,采用程序升温,初始温度50℃,保持5 min;然后以30(℃·min-1)升温至200℃,保持7 min。顶空进样法:顶空瓶加热温度90℃,平衡时间30 min。测得溴代环戊烷分别在4.17~83.4(μg·m L-1)和0.139~2.78(μg·m L-1)范围内呈良好线性关系。回收率分别为100.65%、99.82%。这两种方法均可检测睾酮衍生物AD中溴代环戊烷的残留量,而顶空进样法灵敏度更高,对色谱柱污染较小。     

益气养阴、化痰通络方对冠心病合并2型糖尿病PCI术后患者的近期疗效观察

目的:观察益气养阴、化痰通络方治疗冠心病合并2型糖尿病PCI术后患者的临床疗效。方法:治疗组与对照组均给予常规西药治疗;治疗组给予益气养阴、化痰通络颗粒剂,每日1剂,早晚分服,连服2周,观察2组1个月后中医证候疗效,心电图,BNP,超声心动图的变化。结果:治疗后治疗组中医证侯改善的有效率明显高于对照组(P<0.05);治疗后2组心电图疗效变化不大,无统计学意义(P>0.05);治疗组BNP、超声心动图的改善优于对照组(P<0.05)。结论:益气养阴、化痰通络方能有效改善冠心病合并2型糖尿病PCI术后患者的中医证候、BNP及超声心动图。