血清肿瘤标志物在肺结核初治患者中的临床意义

目的 探讨血清肿瘤标志物水平在肺结核初治患者中的临床意义。方法 收集2017年1月—2018年6月60例肺结核初治患者为肺结核组,60例肺细胞腺癌患者为肺癌组,120例健康体检者为正常对照组,采用化学发光免疫技术测定血清CA125、CA19-9、CA153、CEA、SCC水平,比较肺结核组、肺癌组、正常对照组的血清肿瘤标志物水平及肺结核组患者治疗前后血清肿瘤标志物水平变化。结果 肺结核组患者治疗前血清CA125、CA19-9、CA153、CEA和SCC水平分别为（24.51±12.84） U/mL、（15.21±5.59） U/mL、（12.98±5.78） U/mL、（3.49±0.57） ng/mL和（1.43±0.56） ng/mL,肺癌组为（30.75±12.73） U/mL、（26.40±8.43） U/mL、（30.68±14.66） U/mL、（3.50±0.29） ng/mL和（1.01±0.08） ng/mL,正常对照组为（12.29±3.74） U/mL、（11.73±5.93） U/mL、（9.26±4.26） U/mL、（1.37±0.36） ng/mL和（0.98±0.18） ng/mL,肺结核组和正常对照组的血清CA125、CA19-9和CA153水平均低于肺癌组患者,差异有统计学意义（P<0.05）。肺结核组患者血清CA125、CA19-9、CA153、CEA和SCC水平均高于正常对照组,差异均具有统计学意义（P<0.05）。肺结核组患者治疗后为（15.15±8.47） U/mL、（18.13±9.04） U/mL、（14.57±7.26） U/mL、（3.26±1.64） ng/mL和（1.25±0.33） ng/mL,肺结核患者治疗前后,CA125水平差异具有统计学意义（P<0.05）。Logistic回归分析发现,CA125和CA19-9作为主效应被纳入模型中,利用预测值绘制ROC曲线AUC为0.903（95%CI：0.813~0.993）,敏感性、特异性和理想界值点分别为0.892、1.000和0.30,提高了诊断效能。结论 联合检测血清CA125和CA19-9水平,并利用其建立联合诊断模型,可较好地鉴别肺结核和肺细胞腺癌。同时,血清CA125水平可作为肺结核患者病情进展和评估治疗效果的标志物。     

Clinical Value of Tumor Markers for Determining Cause of Pleural Effusion

Background:

It is often challenging to distinguish tuberculous pleural effusion (TPE) from malignant pleural effusion (MPE); thoracoscopy is among the techniques with the highest diagnostic ability in this regard. However, such invasive examinations cannot be performed on the elderly, or on those in poor physical condition. The aim of this study was to explore the differential diagnostic value of carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and squamous cell carcinoma (SCC) associated antigen in patients with TPE and MPE.

Methods:

Using electrochemiluminescence, we measured the concentration of tumor markers (TMs) in the pleural effusion and serum of patients with TPE (n = 35) and MPE (n = 95). We used receiver operating characteristic (ROC) curve analysis to evaluate the TMs and differentiate between TPE and MPE.

Results:

The cut-off values for each TM in serum were: CA125, 151.55 U/ml; CA199, 9.88 U/ml; CEA, 3.50 ng/ml; NSE, 13.27 ng/ml; and SCC, 0.85 ng/ml. Those in pleural fluid were: CA125, 644.30 U/ml; CA199, 12.08 U/ml; CEA, 3.35 ng/ml; NSE, 9.71 ng/ml; and SCC, 1.35 ng/ml. The cut-off values for the ratio of pleural fluid concentration to serum concentration (P/S ratio) of each TM were: CA125, 5.93; CA199, 0.80; CEA, 1.47; NSE, 0.76; and SCC, 0.90. The P/S ratio showed the highest specificity in the case of CEA (97.14%). ROC curve analysis revealed that, for all TMs, the area under the curve in pleural fluid (0.95) was significantly different from that in serum (0.85; P < 0.001).

Conclusions:

TMs in TPE differ significantly from those in MPE, especially when detected in pleural fluid. The combined detection of TMs can improve diagnostic sensitivity.     

CEA,CA19-9在FOLFOX4方案治疗中晚期结直肠癌中的意义

目的:探讨血清肿瘤标志物癌胚抗原(CEA),糖类抗原CA19-9对结直肠癌诊断及治疗预后判断的临床意义。方法:采用微粒子捕捉免疫发光法检测血清CEA,CA19-9,共测定21例健康成人及32例病理确诊结直肠癌患者,并动态检测32例术后患者及其中9例复发患者的血清水平变化。结果:结直肠癌患者血清CEA106.02ng/ml、CA19-9 136.70U/ml,明显高于对照组5.89ng/ml和17.77U/ml,两组比较有显著统计学差异;32例患者术后血清CEA 15.13ng/ml,CA19-9 29.86U/ml,较术前血清CEA、CA19-9浓度均有显著降低,差异有统计学意义;结直肠癌患者血清CEA,CA19-9水平随临床病理分化程度差而增高,组间比较差异有统计学意义;9例复发患者术前、综合治疗术后及复发后血清CEA分别为176.82、18.83及192.27ng/ml,血清CA19-9分别217.88、37.29及116.50 U/ml,各组间比较均有显著统计学差异。结论:CEA、CA19-9可成为结直肠癌辅助诊断、治疗评估预后及预测复发转移有意义的肿瘤标志物。     

Transient hyperthyroidism after surgery for secondary hyperparathyroidism: a common problem

Background

Postoperative hyperthyroidism occurs in approximately one third of patients following parathyroidectomy due to primary hyperparathyroidism (PHP), but has only rarely been described in secondary hyperparathyroidism (SHP). The frequency, course, and laboratory markers of postoperative hyperthyroidism in SHP remain unknown. Our purpose was to evaluate the frequency and the clinical course of postoperative hypcrthyroidism following surgery of SHP and to determine the diagnostic value of thyroglobulin in this setting.

Material and Methods

A total of 40 patients undergoing parathyroidectomy because of SHP were included in this study. Thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fl4), and thyroglobulin (Tg) were determined one day before and on day 1, 3, 5, 10, and 40 after surgery. At each of these visits patients were clinically evaluated for signs or symptoms of hyperthyroidism.

Results

Biochemical evidence of hyperthyroidism was evident in 77% of patients postoperatively despite of preoperatively normal serum levels. TSH dropped from 1.18 ± 0.06mU/L to 0.15 ± 0.07mU/L (p = 0.0015). Free triiodothyronine (fT3) and fT4 levels increased from 2.86 ± 0.02ng/L and 10.32 ± 0.13ng/L, respectively, to their maximum of 4.83 ± 0.17ng/L and 19.35 ± 0.58ng/L, respectively. Thyroglobulin levels rose from 3.8 ± 0.8ng/mL to 111.8 ± 45.3ng/mL (p < 0.001). At day 40 all thyroid related laboratory values were within normal range. Correlation analysis of postoperative values revealed significant correlations for lowest TSH (r = -0.32; p = 0.038), and highest fT3 (r = 0.55; p < 0.001) and fT4 levels (r = 0.67; p < 0.001) with Tg.

Conclusion

Transient hyperthyroidism is frequent after parathyroidectomy for SHP with Tg being a suitable marker. Awareness of this self-limiting disorder is important to avoid inappropriate and potentially harmful treatment.     

Plasma levels of vitamin E and carotenoids are decreased in patients with nonalcoholic steatohepatitis (NASH)

Objectives

Oxidative stress is suggested to play an important role in the pathogenesis of nonalcoholic steatohepatitis (NASH). The present study was aimed to compare plasma levels of antioxidants in patients suffering from NASH and healthy controls.

Methods

Plasma levels of the antioxidants α-tocopherol, γ-tocopherol, lutein, zeaxanthin, β-cryptoxanthin, lycopene, α-carotene β-carotene were determined in 57 patients with biopsy-proven NASH and 40 healthy controls.

Results

Levels of α-tocopherol (22.4 vs. 26.8 nmol/ ml; p < 0.01), lutein (0.19 vs. 0.33 nmol/ml; p < 0.0001), zeaxanthin (0.04 vs. 0.08 nmol/ml; p < 0.0001), lycopene (0.15 vs. 0.42 nmol/ml; p < 0.0001), α-carotene (0.03 vs. 0.06 nmol/ml; p < 0.005) and β-carotene (0.25 vs. 0.39 nmol/ml; p < 0.01) were significantly decreased in NASH patients compared to controls. Age, aminotransferase status (ALT, AST) and BMI were not correlated with the levels of tocopherols or carotenoids.

Conclusions

Given the decreased levels supplementation of lipophilic antioxidants might be a rational treatment option for patients with NASH.     

Physical activity may compensate for prolonged TV time regarding pulse rate—a cross-sectional study

Background.

The improvement of insulin sensitivity by exercise has been shown to be inhibited by supplementation of vitamins acting as antioxidants.

Objective.

To examine effects of exercise with or without blueberries, containing natural antioxidants, on cardio-metabolic risk factors.

Methods.

Fifteen healthy men and 17 women, 27.6 ± 6.5 years old, were recruited, and 26 completed a randomized cross-over trial with 4 weeks of exercise by running/jogging 5 km five times/week and 4 weeks of minimal physical activity. Participants were also randomized to consume 150 g of blueberries, or not, on exercise days. Laboratory variables were measured before and after a 5 km running-race at maximal speed at the beginning and end of each period, i.e. there were four maximal running-races and eight samplings in total for each participant.

Results.

Insulin and triglyceride levels were reduced while HDL-cholesterol increased by exercise compared with minimal physical activity. Participants randomized to consume blueberries showed an increase in fasting glucose levels compared with controls, during the exercise period (blueberries: from 5.12 ± 0.49 mmol/l to 5.32 ± 0.29 mmol/l; controls: from 5.24 ± 0.27 mmol/l to 5.17 ± 0.23 mmol/l, P = 0.04 for difference in change). Triglyceride levels fell in the control group (from 1.1 ± 0.49 mmol/l to 0.93 ± 0.31 mmol/l, P = 0.02), while HDL-cholesterol increased in the blueberry group (from 1.51 ± 0.29 mmol/l to 1.64 ± 0.33 mmol/l, P = 0.006).

Conclusions.

Ingestion of blueberries induced differential effects on cardio-metabolic risk factors, including increased levels of both fasting glucose and HDL-cholesterol. However, since it is possible that indirect effects on food intake were induced, other than consumption of blueberries, further studies are needed to confirm the findings.     

Symptomatic improvement after catheter ablation of supraventricular tachycardia measured by the arrhythmia-specific questionnaire U22

Introduction

The main indication for ablation of supraventricular tachycardia is symptomatic relief. Generic measures of quality of life are not suitable for direct evaluation of arrhythmia-related symptoms, and a specific tool is needed. The questionnaire U22 quantifies symptoms associated with arrhythmic events. It uses discrete 0–10 scales for quantification of influence of arrhythmia on well-being, intensity of discomfort, type of dominant symptom, and a time aspect that summarizes duration and frequency of spells. We evaluated U22 in a well defined group of patients with paroxysmal supraventricular tachycardia, undergoing an intervention with a distinct end-point and a high success rate.

Methods

Symptoms in patients with accessory pathway and atrioventricular nodal re-entrant tachycardia scheduled for ablation were measured with U22 and SF-36 on admission. The evaluation was repeated after 6 months.

Results

Altogether 58 patients successfully ablated in 2006–2008 completed the four forms (U22 and SF-36 at base-line and follow-up, 210 ± 35 days after ablation). The score for well-being (0–10; 10 being best) increased from 5.9 ± 2.6 to 7.9 ± 1.9 (P < 0.0005). The score for arrhythmia as cause for impairment in well-being (0–10; 10 being highest) decreased from 7.5 ± 2.8 to 2.0 ± 3.1 (P < 0.0005). The time aspect score (0–10) decreased from 4.7 ± 1.5 to 1.4 ± 1.8 (P < 0.0005). The two SF-36 summary measures PCS and MCS increased from 46.9 ± 9.4 to 48.4 ± 10.7 and from 44.9 ± 12.5 to 49.1 ± 9.9 (P = 0.04 and 0.002).

Conclusion

After successful ablation of accessory pathway and atrioventricular nodal re-entrant tachycardia, the U22 protocol detected a relevant increase in arrhythmia-related well-being. Modest improvement in general well-being was detected by the SF-36 protocol.     

Renal impairment after liver transplantation - a pilot trial of calcineurin inhibitor-free vs. calcineurin inhibitor sparing immunosuppression in patients with mildly impaired renal function after liver transplantation

Objectives

Chronic kidney disease is frequent in patients after orthotopic liver transplantation (OLT) and has impact on survival. Patients receiving calcineurin inhibitors (CNI) are at increased risk to develop impaired renal function. Early CNI reduction and concomitant use of mycophenolat mofetil (MMF) has been shown to improve renal function.

Methods

The aim of this trial was to compare dose-reduced CNI/MMF versus CNI-free MMF/prednisone-based treatment in stable patients after OLT with respect to glomerular filtration rate (GFR). 21 patients [GFR 44.9 ± 9.9 mL/min/1.73 m² measured by 99m-Tc-DTPA-clearance, serum creatinine (SCr) 1.5 ± 0.42 mg/dL] were randomized either to exchange CNI for 10 mg prednisone (group 1; n = 8) or to receive CNI at 25% of the initial dose (group 2; n = 13) each in combination with 1000 mg MMF b.i.d.

Results

At month 12 mean SCr (-0.3 ± 0.4 mg/dL, p = 0.031) and GFR improved (8.6 ± 13.1 mL/min/1.73 m², p = 0.015) in group 2 but remained unchanged in group 1. Main side effects were gastroinstestinal symptoms (14.3%) and infections (4.8%). Two biopsy proven, steroid-responsive rejections occurred. In group 1 mean diastolic blood pressure (BP) increased by 11 ± 22 mmHg (p = 0.03).

Conclusions

Reduced dose CNI in combination with MMF but not CNI-free-immunosuppression leads to improvement of GFR in patients with moderately elevated SCr levels after OLT. Addition of steroids resulted in increased diastolic blood pressure presumably counterbalancing the benefits of CNI withdrawal on renal function.     

Left ventricle diastolic function in the patients after coronary arteries bypass graft combined with left ventricle aneurismectomy according to tissue doppler imaging: one year follow-up

Aim

To evaluate left ventricle (LV) diastolic function dynamics in patients after acute myocardial infarction (AMI) after combined operation of coronary artery bypass graft with LV aneurismectomy (CABG + AE) according to the results of tissue Doppler imaging (TDI).

Methods

Forty patients after AMI underwent Doppler echocardiography (EchoCG) with TDI and M‐mode colour‐flow imaging before and in 3 and 12 months after CABG + AE. Mitral annulus (MA) TDI with velocity indices was performed in 4 segments of LV.

Results

Conventional transmitral diastolic Doppler indices before and after CABG + AE remained unchanged. TDI showed significant improvement of LV systolic (systolic movement velocity S: 6.1±0.8, 7.4±1.2 and 6.9±1.3 cm/sec. before and in 3 and 12 months after the operation, respectively, p<0.01) and diastolic function after the operation (MA early diastolic movement velocity ( e''): 7.3 ± 2.1, 8.4 ± 1.5 and 8.9 ± 1.8 cm/s.; ratio of transmitral early‐flow velocity (E) to MA early‐diastolic movement velocity (E/e''): 18.4 ± 2.2, 12.3 ± 1.8 and 11.5 ± 2.3; ratio of E diastolic flow propagation velocity (Vp) 3.1 ± 0.45, 2.2 ± 0.38 and 1.8 ± 0.16 before and in 3 and 12 months after the operation, respectively, p<0.01).

Conclusions

Results of the study demonstrate significant improvement of LV diastolic function in the patient after CABG + AE according to TDI, regardless of transmitral flow pattern. TDI is more sensitive and preload independent method of LV myocardial function evaluation.     

The prevalence of syndrome Z (the interaction of obstructive sleep apnoea with the metabolic syndrome) in a teaching hospital in Singapore

Background

Syndrome Z describes the interaction of obstructive sleep apnoea (OSA) with the metabolic syndrome.

Purpose of study

A pilot study to determine the prevalence of syndrome Z in a teaching hospital in Singapore.

Methods

Patients (age ⩾18 years) recruited for this prospective study had to satisfy three of the following five inclusion criteria: fasting glucose >6.1 mmol/l, blood pressure ⩾130/85 mm Hg, HDL cholesterol <1.04 mmol/l in men and <1.2 mmol/l in women, triglycerides ⩾1.7 mmol/l, and a waist circumference >102 cm in men and >88 cm in women. All subjects underwent standard overnight polysomnography. Overnight fasting glucose and lipid levels were measured and baseline anthropometric data recorded. All sleep studies were scored and reported by a sleep physician. OSA was deemed to be present if the respiratory disturbance index (RDI) was ⩾5, with mild, moderate and severe categories classified according to the Chicago criteria.

Results

There were 24 patients (19 males and five females) of whom 10 were Chinese, eight Malay and five of Indian origin, with one other. Mean age was 48±13.5 years, mean body mass index was 34.9±6.1 kg/m² and mean waist circumference was 111.3±15.7 cm. 23 (95.8%) of the patients had OSA with a mean RDI of 39.6±22.4 events/h with 15 patients (62.5%) in the severe category. The five patients who fulfilled all five criteria for diagnosis of the metabolic syndrome had severe OSA.

Conclusion

The prevalence of OSA in our studied population exhibiting the metabolic syndrome is very high. Therefore, a polysomnogram should always be considered for this subset of patients.     

Renal phenotype of Et-1 transgenic mice is modulated by androgens

Introduction

Activation of the endothelin (ET) system promotes inflammation and fibrosis in various tissues including the kidney. Male ET-1 transgenic mice are characterized by chronic kidney inflammation and renal scarring. We hypothesized that this renal phenotype might be modulated by androgens. Thus the aim of our study was to elucidate the impact of gonadectomy in ET-1 transgenic mice on kidney function and morphology.

Methods

Male ET-1 transgenic mice at the age of 10 weeks were randomly allocated to the following groups: normal ET transgenic mice (ET; n = 17) and ET transgenic mice that underwent castration (ET+cas; n = 12). Study duration was 9 months. Creatinine clearance and protein excretion was monitored. At study end animals were sacrificed and kidneys were harvested for histology/immunhistochemistry.

Results

Castration significantly ameliorated glomerulosclerosis in ET-1 transgenic mice (ET glomerulosclerosis-score: 3.0 ± 0.17 vs ET+cas: 2.4 ± 0.17; p < 0.05) as well as renal perivascular fibrosis (ET fibrosis-score: 3.0 ± 0.14 vs ET+cas: 2.2 ± 0.14; p < 0.05). However, interstitial fibrosis and media/lumenratio of renal arteries remained unaffected by castration. Regarding inflammation, castration significantly reduced the number of CD4-positive cells in renal tissue of ET-1 transgenic mice (ET CD4-positive cells/10000 cells: 355 ± 72 vs ET+cas: 147 ± 28; p < 0.05). Renal tissue contents of CD8 positive cells as well as of macrophages were not affected by castration. Regarding kidney function castration significantly reduced proteinuria in ET-1 transgenic mice whereas creatinine clearance did not differ between study groups.

Conclusion

Our study demonstrates that the renal histopathological phenotype in male ET-1 transgenic mice with regard to glomerulosclerosis, proteinuria, perivascular fibrosis and immune cell immigration is ameliorated by castration. We thus conclude that the effects of ET-1 overexpression on renal tissue injury are modulated by androgens.     

脑脊液肿瘤标志物医学参考值的建立

目的 建立脑脊液肿瘤标志物医学参考值范围.方法 共110例除外原发肿瘤及脑膜癌病患者,采用罗氏E170全自动免疫分析仪及双抗体夹心法分别检测上述患者脑脊液癌胚抗原(CEA)、癌抗原125(CA125)、癌抗原15-3(CA15-3)、糖链抗原19-9(CA19-9)、癌抗原72-4(CA72-4)、人细胞角蛋白19片段(CYFRA21-1)、甲胎蛋白(AFP)、神经元特异性烯醇化酶(NSE)、鳞状上皮细胞癌抗原(SCC)和人绒毛膜促性腺激素(HCG)的含量.结果 (1)脑脊液肿瘤标志物的95%医学参考值范围为:CEA<0.573 μg/L、CA125<2.591 U/ml、CA15-3<2.045 U/ml、CA19-9<2.272 U/ml、CA72-4<1.252 U/ml、CYFRA21-1<1.44 ng/ml、AFP<0.968 μg/L、NSE<57.666.g/ml、SCC<0.5μg/L、HCG<0.769 U/L.(2)脑脊液肿瘤标志物的含量与年龄无相关性(P>0.05).(3)性别对脑脊液肿瘤标志物的含量无影响(P>0.05).结论 建立了脑脊液肿瘤标志物CEA、CA125、CA15-3、CA19-9、CA72-4、CYFRA21-1、AFP、NSE、SCC和HCG的医学参考值范围.     

HBV患者血清YKL-40、CA19-9、GP73水平与其病情相关性

目的 分析HBV患者YKL-40、CA19-9、GP73水平差异及与患者病情轻重程度的相关性,探讨HBV患者病情的判定指标。方法 选取2015年5月—2018年5月收治的100例HBV患者,其中慢性HBV感染组40例、慢性乙型肝炎组36例、HBV相关肝硬化组24例,同期选择我院健康体检的健康者50例作为健康对照组;检测患者血中YKL-40、CA19-9、GP73水平;分析HBV感染患者血清YKL-40、CA19-9、GP73水平与病情轻重程度的相关性。结果 慢性HBV感染、慢性乙型肝炎及HBV相关肝硬化患者血中YKL-40水平分别为（36.38±4.19）ng/mL 、（49.02±4.32）ng/mL、（65.14±5.21）ng/mL ,CA19-9分别为（12.03±1.03）KU/L、（13.84±0.98）KU/L、（16.94±0.81）KU/L,GP73分别为（47.22±5.38）ng/mL 、（98.53±10.24）ng/mL 、（229.85±12.19）ng/mL,均明显高于对照组的（28.19±3.27）ng/mL 、（7.34±0.92）KU/L 、（30.93±3.89）ng/mL,均P=0.000 0。随着慢性HBV感染者、慢性乙型肝炎患者和不同HBV相关肝硬化患者肝脏炎症及纤维化程度加重,患者血中YKL-40、CA19-9和GP73也随之显著增加,均P=0.000 0;YKL-40、CA19-9和GP73均是影响HBV感染患者体内炎症坏死及肝脏纤维化的独立性影响因素,差异有统计学意义（P<0.05）。结论 HBV感染患者血清中YKL-40、CA19-9、GP73水平是HBV感染患者病情轻重程度的独立性影响因素。     

Effects of exercise training on mobilization and functional activity of blood-derived progenitor cells in patients with acute myocardial infarction

Background

The aim of the present study was to determine whether regular exercise training (ET) is effective at promoting the mobilization of CPCs and improving their functional activity in patients with recently acquired myocardial infarction(STEMI). Regular physical training has been shown to improve myocardial perfusion and cardiovascular function. This mayberelatedin part to a mobilization of bonemarrow-derived circulating progenitor cells (CPCs) as well as an enhanced vascularisation.

Methods

37 patients with STEMI were randomly assigned to an ET group or a non-ET group(controls). Two weeks after STEMI, three weeks after regular ET and three months after ET, BNP levels, exercise echocardiography and exercise spiroergometry were evaluated. The number of CD34⁺/CD45⁺ and CD133⁺/CD45⁺CPCs was measured by flow cytometry analysis. The migration capacity of the CPCs was determined with a boyden chamber and the clonogenic capacity by CFU-assay.

Results

In the ET-group the number and migration capacity of CPCs increased significantly after regular exercise training. The BNP level decreased significantly from 121 ± 94 to 75 ± 47 pg/ml (p < 0.001) after the ET period, the left ventricular rejection fraction raised in parallel at peak exercise, and the cardiorespiratory condition improved as demonstrated by an increase of VO₂max (from 1641 ± 522 to 1842 ± 724 ml/min, p < 0.02). These three effects persist till three months after the ET period.

Conclusions

Regular physical activity appears to predispose the mobilization and enhanced functional activity of CPCs, a phenomenon which might lead to an improved cardiac function in patients with recently acquired acute myocardial infarction.     

Improvement of quality of life in patients with concomitant allergic asthma and atopic dermatitis: one year follow-up of omalizumab therapy

Objective

Anti IgE treatment with omalizumab is efficacious in the treatment of patients suffering from allergic asthma, improving asthma control and improving quality of life. Furthermore, this approach could be beneficial for patients with concomitant atopic dermatitis. We assessed quality of life and asthma control in atopic patients with allergic asthma and concomitant atopic dermatitis versus those with asthma and without atopic dermatitis treated with omalizumab.

Methods

A total of 22 patients with severe allergic asthma were treated with omalizumab for 12 months. 13 patients with allergic asthma without concomitant atopic dermatitis (IgE 212 ± 224 IU/ml) and 9 patients with concomitant allergic asthma and atopic dermatitis (IgE 3,528 ± 2,723 IU/ml) were included. Asthma-related quality of life (AQLQ), atopic dermatitis related quality of life (DLQI), and asthma-related treatment were compared between both groups at baseline and after initiating omalizumab treatment.

Results

DLQI was significantly in favor of omalizumab after 2 months in the atopic dermatitis/asthma group (P = 0.01); AQLQ was improved after 6 months in the asthma group (P = 0.01), while no change was seen in AQLQ in the atopic dermatitis/asthma group (P = 0.12). Omalizumab controlled oral corticosteroid use more effective (P < 0.01) in patients with asthma and atopic dermatitis (in 9/9 cases) compared to patients with asthma alone (9/13). Baseline IgE as well as other factors do not predict response to omalizumab.

Conclusions

Omalizumab is effective in improving atopic dermatitis-related quality of life scores and modulates oral corticosteroid use in patients with concomitant asthma and atopic dermatitis in a positive fashion.     

Enhanced effect of soluble transforming growth factor-β receptor II and IFN-γ fusion protein in reversing hepatic fibrosis

Objective

To examine the in vivo anti-fibrotic effect of rat soluble transforming growth factor β receptor II (RsTβRII) and IFN-γ fusion protein (RsTβRII-IFN-γ) in rat hepatic fibrosis model.

Methods

Model rats were divided into five groups and treated i.m. for 8 weeks: 1) fibrotic model group (each rat, 100 μl of 0.9% NaCl day^-1); 2) RsTβRII-IFN-γ treatment group (each rat, 0.136 mg· day^-1); 3) IFN-γ treatment group (each rat, 7.5 MU· day^-1); 4) RsTβRII treatment group (each rat, 0.048 mg· day^-1); and 5) mixture of IFN-γ and RsTβRII treatment group (each rat, IFN-γ 7.5 MU· day^-1+ RsTβRII 0.048 mg· day^-1). After treatment, hepatic fibrogenesis was evaluated by histopathological analysis and measurement of collagen III, α-smooth muscle actin (α-SMA), TGF-β1, TGF-βRII and their mRNA.

Results

Immunohistochemistry, Western blot and real-time RT-PCR showed that RsTβRII-IFN-γ treatment significantly inhibited liver expression of collagen III, α-SMA, TGF-β1 and TGF-βRII at both protein and mRNA levels. Histopathological analysis also showed that the enhanced anti-fibrotic effects were achieved in model rats treated with RsTβRII-IFN-γ.

Conclusion

Our results confirmed that RsTβRII-IFN-γ has the enhanced effects in reversing hepatic fibrosis.     

结直肠癌患者血液肿瘤标记物和粪便隐血结果的临床价值及相关性分析

探讨结直肠癌(CRC)血清标志物［细胞游离DNA (cfDNA)、癌胚抗原(CEA)、碳水化合物抗原19-9 (CA19-9)］以及粪便隐血检测(FOBT)在CRC患者中的临床价值以及这些生物标记物之间的关系。方法 收集来自南京医科大学附属肿瘤医院2001年1月—2021年12月共7537例患者的粪便和血液标志物检测结果,回顾性分析检测结果,研究标记物的诊断价值以及这些标记物与临床病理特征的关系。结果 结肠癌患者血浆cfDNA、血清CEA和CA19-9中位水平分别为17.32 ng/mL、3.59 ng/mL和15.63 U/mL。这3个标志物在直肠癌患者中的中位水平分别为15.61 ng/mL、3.15 ng/mL和12.9 U/mL。结肠癌患者血浆cfDNA和血清CEA、CA19-9水平明显高于直肠癌患者。cfDNA、FOBT、CEA和CA19-9的阳性率分别为67.90%、39.37%、48.67%、23.35%。FOBT和CEA阳性与CRC患者的性别、年龄、肿瘤部位相关。血清cfDNA和CA19-9阳性与年龄、肿瘤部位显著相关。联合检测可显著提高阳性检出率。cfDNA、FOBT、CEA和CA19-9诊断CRC的敏感性分别为56.5%、84.6%、49.9%和59.9%,特异性分别为58.6%、32.3%、84.0%和95.5%。粪便标志物FOBT与血清标志物CEA、CA19-9和cfDNA间没有显著相关性。结论 cfDNA 在CRC中存在较高的阳性率,联合检测cfDNA、CEA、CA19-9及FOBT可提高结直肠癌的检出率。同时血液和粪便来源的标志物在不同临床病理资料间存在差异     

Serum uric acid level in newly diagnosed essential hypertension in a Nepalese population: A hospital based cross sectional study

Objective

To develop the missing link between hyperuricemia and hypertension.

Methods

The study was conducted in Department of Biochemistry in collaboration with Nephrology Unit of Internal Medicine Department. Hypertension was defined according to blood pressure readings by definitions of the Seventh Report of the Joint National Committee. Totally 205 newly diagnosed and untreated essential hypertensive cases and age-sex matched normotensive controls were enrolled in the study. The potential confounding factors of hyperuricemia and hypertension in both cases and controls were controlled. Uric acid levels in all participants were analyzed.

Results

Renal function between newly diagnosed hypertensive cases and normotensive healthy controls were adjusted. The mean serum uric acid observed in newly diagnosed hypertensive cases and in normotensive healthy controls were (290.05±87.05) µmol/L and (245.24±99.38) µmol/L respectively. A total of 59 (28.8%) participants of cases and 28 (13.7%) participants of controls had hyperuricemia (odds ratio 2.555 (95% CI: 1.549-4.213), P<0.001).

Conclusions

The mean serum uric acid levels and number of hyperuricemic subjects were found to be significantly higher in cases when compared to controls.     

Reliability of limb alignment measurement for high tibial osteotomy with a navigation system

Objective

High tibial osteotomy (HTO) is one treatment option for young and active patients with unicompartmental osteoarthritis. The success of this procedure substantially depends on the degree of correction of the mechanical axis. Computer-assisted navigation systems are believed to improve the precision of axis correction through intraoperative real-time monitoring. This study investigates the accuracy of limb alignment measurements with a navigation system on a cadaver specimen.

Materials and methods

The measurements were performed on a well-preserved cadaver specimen with a mechanical leg axis of 4° varus. Data was collected during the HTO workflow. Repeated serial measurements were undertaken by four different surgeons. After these measurements, different landmarks were deliberately set at the wrong place to examine the influence of mistakes during registration.

Results

There was a high intra-and interobserver reliability with a mean mechanical leg axis of 3.9° ± 0.7° and a mean error of 0.6°. The grossly incorrect placement of landmarks for knee and ankle center resulted in an incorrect mechanical leg axis of 1° valgus up to 10° varus.

Conclusion

The computer-assisted navigation system provided precise information about the mechanical leg axis, irrespective of the observer''s experience.