肺癌患者外周血癌胚抗原、细胞角蛋白19mRNA表达水平与肿瘤分期、近期疗效及预后的关系

目的探讨肺癌患者治疗前后外周血癌胚抗原（CEA）、细胞角蛋白19（CK19）mRNA的表达水平及其与肿瘤分期、近期疗效、预后的关系。方法应用TaqMan定量逆转录-聚合酶链反应（RT-PCR）检测78例肺癌患者（鳞癌28例、腺癌40例、小细胞肺癌9例、大细胞肺癌1例）治疗前后、30例肺部良性疾病患者及30名健康对照者外周血癌胚抗原（CEA）、细胞角蛋白19（CK19）mRNA的水平；同时采用酶联免疫吸附法测定肺癌患者治疗前血清CEA和细胞角蛋白19片段（CYFRA21-1）水平。患者随访2年。结果肺癌患者外周血CEA、CK19mRNA阳性率分别为69．2％（54／78）、62．8％（49／78），显著高于肺部良性疾病患者及健康对照者，三者差异有统计学意义（χ^2值分别为37．65、41．54；27．41、30．84，P均〈0．01）。鳞癌组CK19mRNA阳性率最高，腺癌组CEAmRNA阳性率最高。不同分期肿瘤患者间CEA、CK19mRNA阳性率差异无统计学意义（χ^2值分别为3．63、3．81，P〉0．05）。肺癌患者外周血CEA、CK19mRNA的阳性率显著高于CEA、CYFRA21-1蛋白水平；手术后CEA、CK19mRNA阳性率显著下降；化疗后阳性率下降不明显。化疗前CEAmRNA阳性患者的中位生存期明显低于阴性患者（分别为8．5、11．7个月），化疗前CK19mRNA阳性患者的中位生存期明显低于阴性患者（分别为8．9、12．3个月）；术前CEAmRNA阳性患者肿瘤复发或转移率（29．4％）高于术前阴性患者（7．7％），术前CK19mRNA阳性患者肿瘤复发或转移率（18．8％）高于术前阴性患者（7．1％）。结论检测肿瘤患者外周血CEA、CK19mRNA水平对于预测肿瘤细胞微转移有一定的临床意义，有助于评估手术疗效及预测预后。CEA、CK19mRNA表达水平与肿瘤分期无关。CEA、CK19基因检测的敏感性优于蛋白水平的检测，有助于肺癌的辅助诊断。     

实时定量RT-PCR检测大肠癌病人外周血CK-20mRNA、CEA mRNA的研究

目的 研究大肠癌病人外周血CK20mRNA、CEA mRNA的表达，并探讨其临床意义。方法采用实时定量RT-PCR方法，检测大肠癌病人术前外周血CK20mRNA、CEA mRNA，并与临床分期进行相关分析。结果47例大肠癌病人外周血中CK20mRNA的阳性率为36．17％，CEAmRNA的阳性率为40．43％。统计结果显示CK20mRNA、CEA mRNA的拷贝数与Dukes分期无相关性(P分别为0．532及0．964)。结论单次采血定量CK20mRNA、CEAmRNA尚不能作为术前临床分期的一个参考指标，不同病人术前的CK20mRNA、CEAmRNA值不具备可比性。     

CK19与CEA在非小细胞肺癌外周血微转移中的对比研究

目的检测非小细胞肺癌（NSCLC）患者外周血细胞角蛋白（CK19）及癌胚抗原（CEA）的表达,探讨对检测NSCLC微转移的可行性。方法应用RT—PCR技术检测48例NSCLC患者、15例肺良性疾病（BLD）患者和10例健康人外周血CK19及CEA mRNA的表达。结果NSCLC患者外周血中CK19及CEA mRNA的阳性表达率分别为68．75％、58．33％,在BLD组中表达率分别为13．33％、6．67％,而对照组外周血中均无表达,NSCLC组CK19及CEA表达均高于BLD组及对照组（P〈0．05）。外周血CK19及CEA的表达与临床分期及淋巴结转移密切相关,与病理类型及分化程度无关。结论CK19与CEA均可作为检测NSCLC患者外周血微转移较为合适的分子标志物,联合检测有助于提高检测的阳性率。     

肿瘤标志物在肺癌诊断、病理分型和临床分期中的价值

目的研究血清肿瘤相关抗原125（CA125）、199（CA199）、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21—1）在肺癌诊断、病理分型和临床分期中的价值。方法选取郑州大学第一附属医院2011年6月至2012年9月入院患者309例血清标本,采用电化学免疫荧光发光法检测血清肿瘤标志物的浓度。结果肺癌患者5种血清肿瘤标志物水平均高于肺部良性病变组。单项检测,腺癌、鳞癌、小细胞肺癌（SCCL）敏感度最高者分别为CYFRA21—1和CEA、CYFRA21—1、NSE。联合检测CA125＋CEA＋NSE＋CYFRA21—1敏感度达87．26％。CA125、CEA、CYFRA21—1在肺癌不同TNM分期的表达阳性率及表达高度不同。结论血清5种肿瘤标志物诊断肺癌价值较高,其中CYFRA21—1诊断价值最大,联合检测可以提高肺癌诊断敏感度。CA125、CEA、CYFRA21—1在肺癌临床分期中价值较大。     

血清CEA、SCC、CYFRA21—1、ProGRP联合检测在肺癌诊断中的价值

目的 探讨血清癌胚抗原（CEA）、鳞状细胞癌抗原（SCC）、细胞角蛋白19片段（CYFRA21-1）、胃泌素释放肽前体（ProGRP）联合检测在肺癌诊断中的价值。方法 选取2011年3月至2013年8月我院收治的60例已经确诊的肺癌患者,将其作为临床研究对象（实验组）,另选取60例良性肺病患者作为对照（对照组）,采用酶联免疫分析法检测两组患者的血清CEA、SCC、ProGRP水平,并用电化学发光法测定CYFRA21-1水平,对CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的阳性率与水平进行比较。结果 实验组血清CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的阳性率分别为53.3%、21.7%、41.7%、10.0%,对照组血清CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的阳性率分别为10.0%、15.0%、8.3%、1.7%。实验组血清CEA、SCC、CYFRA21-1和ProGRP的阳性率均明显高于对照组,P〈0.05;实验组血清CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的水平分别为20.1±2.3、1.0±0.5、8.5±1.6、179.5±37.8,对照组血清CEA、SCC、CYFRA21-1和ProGRP 4种肿瘤标志物的水平分别为3.5±2.1、0.8±0.4、1.1±0.7、4.5±0.6。实验组的血清CEA、SCC、CYFRA21-1和ProGRP水平均明显高于对照组,P〈0.05。结论 采用血清CEA、SCC、CYFRA21-1和ProGRP联合检测可以提高肺癌的诊断效率,对肺癌诊断有很大的临床价值,为患者的疾病治疗争取到了时间,值得在临床大力推广应用。     

肺癌患者血清非小细胞肺癌相关抗原细胞角蛋白片段21－1的表达研究

目的检测血清细胞角蛋白片段21—1（CYFRA21—1）、肿瘤标志物癌胚抗原（CEA）的水平,探讨其在肺癌诊断中的价值。方法检测60例肺癌和56例消化道恶性肿瘤患者血清中CYFRA21-1、CEA的水平,采用χ^2检验对数据结果进行统计分析。结果肺癌组（研究组）CYFRA21—1的阳性率为76．7％,明显高于消化道恶性肿瘤组41．1％（对照组）,（P〈0．01）,也明显高于同组CEA的阳性率43．3％（P〈0．01）。结论血清CYFRA21—1较CEA在肺癌诊断中有更高的敏感性。     

血清CEA、NSE、SCC-Ag、CYFRA21-1联合检测对肺癌的诊断价值

目的研究血清肿瘤标志物癌胚抗原（CEA）、神经元特异性烯纯化酶（NSE）、鳞状细胞癌相关抗原（SCC-Ag）及细胞角蛋白（CYFRA21-1）对肺癌诊断的价值。方法用酶联免疫吸附实验法（ELISA）检测对97例肺癌患者、90例良性肺疾病患者及85例健康对照组进行血清CEA、NSE、SCC-Ag及CYFRA21-1水平,并计算上述指标单项及联合检测在肺癌诊断中的敏感度和特异度。结果肺癌患者的血清CEA、NSE、SCC-Ag及CYFRA21-1水平均明显高于良性肺部组和健康对照组（P〈0.05）;4项标记物在不同病理类型肺癌中总体比较均有差异,其中CEA阳性率以腺癌最高（55.26%）,SCC-Ag、CYFRA21-1阳性率以鳞癌最高（分别为70.43%,72.38%）,NSE阳性率以小细胞肺癌最高（67.92%）。血4项标志物联合检测肺癌阳性率（92.78%）高于单项检测结果。结论血清CEA、NSE、SCC-Ag、CYFRA21-1联合检测不仅有助于区分肺癌的病理分型,还能明显提高肺癌诊断的敏感性和检出率。     

动脉化疗对进展期胃癌CEA mRNA及CK19 mRNA表达的影响

目的:探讨外周血细胞CEAmRNA,CK19mRNA水平与胃癌EAP方案介入化疗近期疗效相关意义.方法:选择30例中晚期胃癌患者(Ⅱ期3例,Ⅲ期15例,Ⅳ期12例),于EAP(VP-16 ADM CBP)介入化疗前2-3d及化疗后2-3wk取外周血,全自动发光免疫法检测血清CEA及TPA,逆转录聚合酶链反应检测CEA及CK19mRNA.用超声内镜(EUS)结合CT测量肿块对化疗的有效率(CR PR)情况.结果:介入化疗前后外周血CEA及CK19mRNA均有显著差异[CEA:60.0%(18/30)vs33.3%(10/30),χ2=4.29,P<0.05;CK19:73.3%(22/30)vs46.7%(14/30),χ2=4.34,P<0.05].CEA及CK19mRNA联合检测阳性率在介入化疗前后也有显著差异[90.0%(27/30)vs50.0%(15/30),χ2=8.52,P<0.05].影像学诊断显示,外周血CEAmRNA,CK19mRNA联合检测阳性患者治疗前后分别为16例及5例(χ2=8.86,P<0.05).结论:外周血细胞CEAmRNA、CK19mRNA水平在EAP方案介入化疗后阳性率显著下降,CEAmRNA、CK19mRNA联合检测的敏感性高于血清CEA、TPA联合检测,可反应EAP方案介入化疗后肿瘤体积的变化情况.     

肺癌患者血清和胸水中常用肿瘤标志物的检测

目的探讨肺癌患者血清和胸水中6种肿瘤标志物的检测意义，并选择较理想的肿瘤标志物组合。方法应用ELISA检测120例肺癌患者和90例肺部良性疾病患者血清和胸水中以及50例健康人血清中神经元特异性烯醇化酶（NSE）、胃泌素释放肽前体（pro-GRP）、细胞角质蛋白19（CYFRA21-1）、鳞癌抗原（SCC）、p53抗体和癌胚抗原（CEA）的水平含量。结果肺癌患者血清和胸水6种肿瘤标志物水平均明显高于健康人组和肺部良性疾病组（P〈0．01）。肺部良性疾病组胸水中NSE、CYFRA21—1和CEA的假阳性率较高。血清NSE、pro—GRP在小细胞肺癌中的水平和敏感性明显高于其他类型的肺癌（P〈0．01）；血清CYFRA21-1、SCC在肺鳞癌中的水平和敏感性明显高于其他类型的肺癌（P〈0．01）。6种血清肿瘤标志物经组合后，在特异性下降不大的情况下。敏感性明显高于任一单项肿瘤标志物（P〈0．01）。结论6种肿瘤标志物的检测对于肺癌的辅助诊断有一定的临床意义。血清NSE、pro-GRP可作为联合检测小细胞肺癌的标志物组合；血清CYFRA21-1、SCC可作为联合检测肺鳞癌的标志物组合；血清NSE、CYFRA21-1、CEA可作为联合检测非小细胞肺癌的标志物组合。     

血清CEA、CYFRA21—1、NSE联合检测在肺癌诊断中的临床价值

目的探讨血清癌胚抗原（CEA）、细胞角蛋白19片段21—1（CYFRA21—1）、神经元特异性烯醇化酶（NSE）联合检测诊断肺癌的临床价值。方法用电化学发光免疫分析技术检测140例肺癌、189例肺良性疾病患者的血清CEA、CYFRA21-1、NSE表达水平。结果肺癌患者的血清CEA、CYFRA21—1、NSE均明显高于肺良性疾病患者（P均〈0．05）;三者联合检测诊断肺癌的敏感性明显高于其单独检测,且在肺癌不同病理类型中三者联合检测的阳性率有统计学差异（P均〈0．05）。结论血清CEA、CYFRA21—1、NSE是诊断肺癌较好的标志物,三者联合检测可明显提高肺癌诊断的敏感性。     

Strikes, flooding, rats, and leptospirosis in Marseille, France

Objectives

The aim of this study was to examine the mechanisms by which weather conditions, the incidence of Leptospira in reservoir populations, and various socio-ecological factors are driving the emergence of leptospirosis in Marseille, France.

Methods

Over the last 30 years our laboratory has surveyed all human cases of leptospirosis in Marseille using clinical, epidemiological, serological, and molecular tools. Data for the weather conditions in Marseille were collected from the official meteorological station, and garbage management strikes were monitored through the local press. Rats were trapped in alleys near to where the patients may have acquired leptospirosis.

Results

Three new cases of autochthonous leptospirosis are reported. The global tendency for rainfall showed a slight increase over the period under analysis. The index case of leptospirosis occurred after a heavy rainfall with flooding. Over the last 10 years Marseille has undergone 82 days of garbage management strikes. Leptospira DNA was detected in two of 11 rats.

Conclusions

The emergence of leptospirosis has become a public health problem in Marseille, and is associated with a combination of heavy rainfall and garbage collection strikes in which garbage is left on the street and thereby contributes to the expansion of the rat population on the surface.     

Changes in Hypertension Prevalence,Awareness, Treatment,and Control in High-, Middle-, and Low-Income Countries: An Update

The aim of this paper was to critically evaluate recent publications on hypertension treatment and control in regions by income. Prevalence of hypertension is increasing worldwide, most prominently in low-income countries. Awareness, treatment, and control are most successful in North America while remaining a challenge in middle- and low-income countries. Easy access to medical care and aggressive use of pharmacotherapy are the key strategies which have proved to be successful in reducing the burden of hypertension on the population level.     

Sigma-receptors in endocrine organs: identification, characterization, and autoradiographic localization in rat pituitary, adrenal, testis, and ovary

We have used a variety of selective radioligands to identify and localize sigma- and phencyclidine (PCP)-binding sites in rat endocrine organs. [3H]Haloperidol-labeled sigma-receptors were identified in membrane homogenates of rat pituitary, adrenal, testis, and ovary which had kinetic and pharmacological characteristics similar to those of the well characterized sigma-receptors in rat cerebellum. The highest density of sigma-receptors was present in the ovary, with progressively lower densities present in the testis, pituitary, adrenal, and cerebellum, respectively. In autoradiographic studies, sigma-receptors [labeled with d-3-(3-hydroxyphenyl)N-(1-propyl-2,3-[3H]piperidine or [3H]1,3-di-(2-tolyl)guanidine] were discretely localized within the endocrine tissues. In the pituitary, the highest density of sigma-receptors was found in the anterior lobe. In the adrenal, sigma-receptors were localized primarily in the cortex. In the testis, sigma-receptors were present in highest concentrations in the ductuli efferentes and ductus epididymis; lower densities of binding sites were present in the seminiferous tubules, and no binding was seen in the interstitial tissue. In the ovary, sigma-receptors were localized in high density in the maturing follicles, and lower densities were present in resting follicles. After hypophysectomy, there were relative increases in the densities of sigma receptors in the remaining tissue in the adrenal gland and testis. In contrast, hypophysectomy resulted in a marked depletion of sigma-binding sites in the ovary. The data from hypophysectomized rats indicate that the highest densities of sigma-receptors in the ovary are localized to (LH-dependent) maturing follicles, while sigma-binding sites in adrenal and testis are localized to cells that are not dependent on trophic maintenance by the pituitary. In contrast, high affinity PCP receptors were not detected in pituitary, adrenal, testis, or ovary either by homogenate binding studies with 3,4-[3H]N-[1-(2-thienyl)cyclohexyl]piperidine or in vitro autoradiography using 3,4-[3H]N-[1-(2-thienyl)cyclohexyl]piperidine and d-[3H]5-methyl-10,11-dihydro-5H-dibenzo-[a,d] + cyclohepten-5,10-imine. In summary, the data suggest that the reported endocrine effects of PCP and the prototypic sigma-receptor agonist N-allylnormetazocine are probably mediated either through direct action on sigma-receptors in the pituitary and/or target endocrine organs or by actions on sigma- and/or PCP receptors in brain.     

Heterogeneity in expression and subcellular localization of claudins 2, 3, 4, and 5 in the rat liver, pancreas, and gut

BACKGROUND & AIMS: Paracellular transport varies widely among epithelia of the gastrointestinal tract. We determined whether members of the claudin family of tight junction proteins are differentially expressed consistent with a potential role in creating these variable properties. METHODS: Rabbit polyclonal antibodies were produced against peptides from claudins 2 through 5. The distribution of individual claudins was detected by immunoblotting, and their cell type and subcellular localization were determined by immunofluorescence on cryosections of rat liver, pancreas, stomach, and small and large intestine. RESULTS: All antibodies detected single bands of the expected size on immunoblots and were monospecific based on peptide competition studies. Immunoblotting detected strong differences among tissues in the expression level of each claudin. Immunolocalization confirmed these differences and revealed striking variations in expression patterns. In the liver, claudin 2 shows a lobular gradient increasing from periportal to pericentral hepatocytes, claudin 3 is uniformly expressed, claudin 4 is absent, and claudin 5 is only expressed in endothelial junctions. In the pancreas, claudin 2 is only detected in junctions of the duct epithelia, claudin 5 only in junctions of acinar cells, whereas claudin 3 and 4 are in both. Among differences in the gut are a crypt-to-villus decrease in claudin 2, a highly restricted expression of claudin 4 to colonic surface cells, and the finding that some claudins can be junctional, lateral, or show a gradient in junctional vs. lateral localization along the crypt-to-villus surface axis. CONCLUSIONS: Claudins have very different expression patterns among and within gastrointestinal tissues. We propose these patterns underlie differences in paracellular permeability properties, such as electrical resistance and ion selectivity that would complement known differences in transcellular transport.     

Rickettsia, Ehrlichia, Anaplasma, and Bartonella in ticks and fleas from dogs and cats in Bangkok

Flea and tick specimens (5-10 fleas or ticks) on dogs and cats from various sites in Bangkok were tested by polymerase chain reaction and DNA sequencing to detect DNA of bacteria Rickettsia (gltA and 17?kDa genes), Anaplasmataceae (16S rRNA gene), and Bartonella (pap31 and its genes). We confirmed that Rickettsia sp. related to Rickettsia felis was detected in 66 of 98 (67.4%) flea specimens from dogs, whereas 8 Bartonella henselae and 2 Bartonella clarridgeiae were detected in 10 of 54 (18.5%) flea specimens from cats. Further, this work provides the first evidence of 10 Ehrlichia canis (3.3%), 7 Anaplasma platys (2.3%), and 2 Wolbachia spp. (0.66%) in 304 Rhipicephalus sanguineus tick specimens in Thailand.     

Strategy use, recall, and recall organization in young, middle-aged, and elderly adults

The application and transfer of free recall study strategies were examined for young, middle-aged, and elderly adults. Subjects were either instructed to use clustering and imagery, instructed to use their own study strategies, or given standard free recall instructions. Subjects at all age levels showed high initial use of categorization and low initial use of imagery. Subject-reported imagery increased after training, but categorization was the only strategy associated with higher recall levels. Training produced increases in recall clustering that were apparent only on a transfer list. The results provided evidence that adult age differences in memory occur even when middle-aged and elderly adults show evidence of categorization in recall.     

Strategy use,recall, and recall organization in young,middle-aged,and elderly adults

Abstract

The application and transfer of free recall study strategies were examined for young, middle-aged, and elderly adults. Subjects were either instructed to use clustering and imagery, instructed to use their own study strategies, or given standard free recall instructions. Subjects at all age levels showed high initial use of categorization and low initial use of imagery. Subject-reported imagery increased after training, but categorization was the only strategy associated with higher recall levels. Training produced increases in recall clustering that were apparent only on a transfer list. The results provided evidence that adult age differences in memory occur even when middle-aged and elderly adults show evidence of categorization in recall.