Caution! Overestimation of treatment effects of corticosteroid therapy for community-acquired pneumonia in a meta-analysis of randomized controlled trials

It is well known that a meta-analysis of randomized controlled trials aims to increase the power and precision of the estimated intervention effects. However, when a meta-analysis includes a limited number of patients and a small number of events, overestimation of intervention effect estimates may occur and could cause spurious results. Although many biases can cause the overestimation, random error may be the most common cause. Trial sequential analysis (TSA) can explore the independent effect of random error on intervention effect estimates in meta-analyses and protect meta-analyses against overestimation due to random error.     

血清LSA测定在恶性肿瘤临床诊断中的初步应用

本文根据Svennerholm和蒋谷人等的方法略加改良,测定了蚌埠地区113例正常人,71例恶性肿瘤患者和82例非肿瘤疾病患者血清脂质结合唾液酸(LSA)的含量。正常值为12.4mg/dl(SD=±3.6mg/dl),71例不同肿瘤患者的平均值为28.2mg/dl(SD=±9.7mg/dl),阳性率为88.7％,82例非肿瘤疾病患者的平均值为16.82mg/dl(SD=±5.4mg/dl),假阳性率为17％。方法的灵敏度,重复性(平均CV=3.6％)和回收率(平均回收率=101.4％)测定结果是满意的。本研究的初步结果表明,血清LSA测定对肺癌、白血病、胃癌和食管癌具有一定的临床诊断价值。     

胸腹水中唾液酸含量在鉴别良恶性疾病上的价值

本文测定恶性、炎性和肝硬化3组胸腹水中的总唾液酸(TotalSialic Acid TSA)和脂质结合唾液酸(Lipid-bound Sialic Acid LSA)含量,结果表明恶性组和炎性组的 TSA 和 LSA 明显高于肝硬化组,但恶性组和炎性组的 TSA 和 LSA 则无明显差异。恶性、炎性和肝硬化组的 TSA 值分别为499.52±183.98mg/L、508.68±208.79mg/L 和117.71±70.46mg/L;LSA则分别为146.28±103.62mg/L、115.26±72.13mg/L 和58.90±35.46mg/L。以肝硬化组的 TSA+2SD 作为恶性组和肝硬化组的鉴别值,其敏感性为88%,特异性为90.47%,有效性为89.13%。LSA 则无鉴别价值。     

Natural indoles,indole-3-carbinol and 3,3′-diindolymethane,inhibit T cell activation by staphylococcal enterotoxin B through epigenetic regulation involving HDAC expression

Staphylococcal enterotoxin B (SEB) is a potent exotoxin produced by the Staphylococcus aureus. This toxin is classified as a superantigen because of its ability to directly bind with MHC-II class molecules followed by activation of a large proportion of T cells bearing specific Vβ-T cell receptors. Commonly associated with classic food poisoning, SEB has also been shown to induce toxic shock syndrome, and is also considered to be a potential biological warfare agent because it is easily aerosolized. In the present study, we assessed the ability of indole-3-carbinol (I3C) and one of its byproducts, 3,3′-diindolylmethane (DIM), found in cruciferous vegetables, to counteract the effects of SEB-induced activation of T cells in mice. Both I3C and DIM were found to decrease the activation, proliferation, and cytokine production by SEB-activated Vβ8 ⁺ T cells in vitro and in vivo. Interestingly, inhibitors of histone deacetylase class I (HDAC-I), but not class II (HDAC-II), showed significant decrease in SEB-induced T cell activation and cytokine production, thereby suggesting that epigenetic modulation plays a critical role in the regulation of SEB-induced inflammation. In addition, I3C and DIM caused a decrease in HDAC-I but not HDAC-II in SEB-activated T cells, thereby suggesting that I3C and DIM may inhibit SEB-mediated T cell activation by acting as HDAC-I inhibitors. These studies not only suggest for the first time that plant-derived indoles are potent suppressors of SEB-induced T cell activation and cytokine storm but also that they may mediate these effects by acting as HDAC inhibitors.     

Molecular Epidemiology and Genetic Diversity of Orientia tsutsugamushi from Patients with Scrub Typhus in 3 Regions of India

Scrub typhus, an acute febrile illness that is widespread in the Asia-Pacific region, is caused by the bacterium Orientia tsutsugamushi, which displays high levels of antigenic variation. We conducted an investigation to identify the circulating genotypes of O. tsutsugamushi in 3 scrub typhus–endemic geographic regions of India: South India, Northern India, and Northeast India. Eschar samples collected during September 2010–August 2012 from patients with scrub typhus were subjected to 56-kDa type-specific PCR and sequencing to identify their genotypes. Kato-like strains predominated (61.5%), especially in the South and Northeast, followed by Karp-like strains (27.7%) and Gilliam and Ikeda strains (2.3% each). Neimeng-65 genotype strains were also observed in the Northeast. Clarifying the genotypic diversity of O. tsutsugamushi in India enhances knowledge of the regional diversity among circulating strains and provides potential resources for future region-specific diagnostic studies and vaccine development.     

曲古霉素A和5-氮杂胞苷对高糖诱导损伤的胰岛β细胞的保护作用

目的 探讨高糖诱导下曲古霉素A（TSA）和5-氮杂胞苷（5-AzaC）对胰岛β细胞增殖、凋亡及功能的影响. 方法 体外培养大鼠胰岛素瘤（RIN-m5f）细胞至指数增长期,根据干预方案分为空白对照（NC）组、高糖诱导（HG）组、0.05、0.10 μmol/L TSA干预组、0.63、1.25 μmol/L 5-AzaC干预组、0.10 μmol/L TSA＋1.25 μmol/L 5-AzaC联合干预组.检测RIN-m5f细胞增殖活性、细胞凋亡率、葡萄糖刺激胰岛素分泌能力. 结果 0.05、0.10 μmol/L TSA干预组、0.63、1.25 μmol/L 5-AzaC干预组及联合干预组的细胞增殖活性均高于HG组,而细胞凋亡率均低于HG组（P＜0.05）.在3.3 mmol/L及25 mmol/L葡萄糖刺激时,各组葡萄糖刺激胰岛素分泌量均高于HG组（P＜0.05）. 结论 TSA和5-AzaC可抑制高糖诱导的胰岛β细胞凋亡和恢复β细胞的胰岛素分泌功能.     

低氧诱导下舌鳞癌SCC-6细胞中HIF-1α、VEGF的表达及TSA对其表达的抑制

目的:观察低氧与人舌鳞状细胞癌SCC-6细胞中HIF-1α、VEGF表达的相关性,曲古抑菌素A(TSA)对其表达的抑制作用,初步探讨其作用机制。方法:体外培养的舌鳞状细胞癌SCC-6细胞,经不同作用时间去铁胺处理,模拟低氧条件培养后,RT-PCR检测HIF-1α、VEGF的mRNA表达,Western Blot检测其蛋白表达;模拟低氧条件下,不同浓度、时间梯度TSA处理SCC-6细胞后,分别检测HIF-1α、VEGF的mRNA及蛋白表达。结果:①低氧下SCC-6细胞HIF-1α蛋白表达增加,但其mRNA的表达不受影响;作为HIF-1α下游基因的VEGF的mRNA和蛋白表达,随HIF-1α蛋白表达增加而增加;②低氧下,TSA可抑制HIF-1α的蛋白表达及VEGF的mRNA和蛋白表达,并呈量效和时效关系,但HIF-1α的mRNA表达不受影响;③HIF-1α的调节在蛋白水平。结论:体外条件下,模拟低氧可诱导舌鳞状细胞癌SCC-6细胞中HIF-1α蛋白、其下游基因VEGF的mRNA和蛋白的表达增加。TSA可抑制HIF-1α的蛋白表达,进而抑制其下游基因VEGF的表达,从而发挥抗肿瘤血管生成的作用,并且呈量效和时效关系。