新型甲型H1N1流感危重症存活和死亡病例的临床特点分析

Objective To understand the clinical features of critically ill patients with pandemic 2009 influenza A(H1N1)and investigate the risk factors associated with death cases. Methods The clinical features of 55 critically ill patients with pandemic 2009 influenza A(H1N1)viral infection hospitalized at Beijing Ditan Hospital from October 3 to December 15,2009 were retrospectively analyzed,and a comparative analysis was performed on the manifestations of the survival and the death groups of patients. Results There were 31 males and 24 females.The age ranged from 10 months to 84 year old,and the mean(SD)was 38(20)year old.The critically ill cases were more in patients under age 65(48/55),with obesity(33/49),with underlying diseases(26/49),and pregnancy(6/24).Both the survivors and non-survivors of patients had high fever,cough,sputum(some sputum with blood),dyspnea,r(a)les of both lungs fields.and all further developed severe pneumonia.The patients also showed respiratory failure(54/55)and ARDS(26/55).All of them received oseltamivir therapy,and 38 patients received mechanical ventilation and 30 were giyen steroid therapy.Secondary infection occurred in 27 cases.and ventilatorassociated pneumonia happened in 10 patients.In the early stage of onset,C-reactive protein(CRP) increased [ (131 ± 130)mg/L] and low counts of T lymphecytes were present [ CD4+ , CD8+T was (217 ±139)/μl and (162 ± 82)/μl]. With the progress of disease, the non-survival cases had persistently increased CRP and the counts of T lymphocytes did not recover, while the secondary fungal infection was significantly higher than in the survivor cases (P <0. 05). By using BMI, underlying diseases, ARDS, the day of Oseltamivir initiated, steroid therapy, following bacterial and fungal infection as variables through logistic regression analysis, it was shown that higher BMI and following fungal infection were associated with higher fatal risks ( OR was 6. 512, 19. 631 respective0ly, both of P value was low than 0. 05 ). There was no death case who received oseltamivir treatment within 48 hours of onset of disease. Conclusions Critical illness in pandemic 2009 influenza A (H1N1)was associated with patients under age 65, with obesity,underlying diseases, and pregnancy. Persistently increased CRP and lower counts of T lymphocytes were associated with unfavorable prognosis. The patients with higher BMI and secondary fungal infection had higher fatal risks. Oseltamivir treatments at early stage would probably reduce mortality.     

新型甲型H1N1流感聚集性发病患者的临床特点和诊治体会

Objective To describe the clinical characteristics of 3 community outbreaks of the novel influenza A (H1N1),and to compare the treatment effects of the traditional Chinese medicine with or without Oseltamivir. Method The clinical records of 234 patients in 3 community outbreaks of the novel influenga A(H1N1)infection in June (n=56),August (n=96)and October (n=82) of 2009 were analyzed,and the treatment effects of the traditional Chinese medicine with or without Oseltamivir were evaluated. Results The baseline characteristics,including age,temperature,indices of blood tests,hepatic and renal functions were distributed evenly between the 2 treatment groups.The overall analysis suggested that there was no significant difference between the 2 treatment groups in the duration of clinical symptoms(P>0.05),the duration of fever(P>0.05),and the hospitalization days(P>0.05).However,an analysis stratified by the temperature (≥39℃ or <39℃)suggested that patients treated by the traditional Chinese medicine with Oseltamivir tended to suffer a shorter duration of fever [40.5(37.3.42.0) vs 22.0(10.5,30.8)hr,P<0.01]]in the higher temperature group. Conclusions The traditional Chinese medicine was equivalent to oseltamivir in treating patients with the novel influenza A (H1N1) infection with lower temperature (<39℃).Oseltamivir was effective in shortening the duration of fever in patients with temperature higher than 39℃.     

新型甲型H1N1流感聚集性发病患者的临床特点和诊治体会

Objective To describe the clinical characteristics of 3 community outbreaks of the novel influenza A (H1N1),and to compare the treatment effects of the traditional Chinese medicine with or without Oseltamivir. Method The clinical records of 234 patients in 3 community outbreaks of the novel influenga A(H1N1)infection in June (n=56),August (n=96)and October (n=82) of 2009 were analyzed,and the treatment effects of the traditional Chinese medicine with or without Oseltamivir were evaluated. Results The baseline characteristics,including age,temperature,indices of blood tests,hepatic and renal functions were distributed evenly between the 2 treatment groups.The overall analysis suggested that there was no significant difference between the 2 treatment groups in the duration of clinical symptoms(P>0.05),the duration of fever(P>0.05),and the hospitalization days(P>0.05).However,an analysis stratified by the temperature (≥39℃ or <39℃)suggested that patients treated by the traditional Chinese medicine with Oseltamivir tended to suffer a shorter duration of fever [40.5(37.3.42.0) vs 22.0(10.5,30.8)hr,P<0.01]]in the higher temperature group. Conclusions The traditional Chinese medicine was equivalent to oseltamivir in treating patients with the novel influenza A (H1N1) infection with lower temperature (<39℃).Oseltamivir was effective in shortening the duration of fever in patients with temperature higher than 39℃.     

重症监护病房系统性红斑狼疮患者预后因素分析

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.     

重症监护病房系统性红斑狼疮患者预后因素分析

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.     

重症监护病房系统性红斑狼疮患者预后因素分析

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.     

重症监护病房系统性红斑狼疮患者预后因素分析

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.     

重症监护病房系统性红斑狼疮患者预后因素分析

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.     

重症监护病房系统性红斑狼疮患者预后因素分析

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.     

重症监护病房系统性红斑狼疮患者预后因素分析

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.     

Cytochrome 1A1 and 1B1 gene diversity in the Zanzibar islands

Amodiaquine (AQ) is a 4‐aminoquinoline widely used in the treatment of malaria as part of the artemisinin combination therapy (ACT). AQ is metabolised towards its main metabolite desethylamodiaquine mainly by cytochrome P450 2C8 (CYP2C8). CYP1A1 and CYP1B1 play a minor role in the metabolism but they seem to be significantly involved in the formation of the short‐lived quinine‐imine. To complete the genetic variation picture of the main genes involved in AQ metabolism in the Zanzibar population, previously characterised for CYP2C8, we analysed in this study CYP1A1 and CYP1B1 main genetic polymorphisms. The results obtained show a low frequency of the CYP1A1*2B/C allele (2.4%) and a high frequency of CYP1B1*6 (approximately 42%) followed by CYP1B1*2 (approximately 27%) in Zanzibar islands. Genotype data for CYP1A1 and CYP1B1 show a low incidence of fast metabolisers, revealing a relatively safe genetic background in Zanzibar’s population regarding the appearance of adverse effects.     

血管生成素1和血栓调节蛋白1在STZ鼠肾脏中的表达及其意义

目的：探讨血管生成素1（angiopoietin-1,Ang-1）和血栓调节蛋白1（thrombomodulin-1,TM-1）在糖尿病鼠肾脏中的表达变化及其与肾脏微血管病变的关系. 方法：STZ诱导的糖尿病大鼠肾病模型,设正常对照和模型组,于2、4、8、12、16、20、24周,采用免疫组化观察肾脏Ang-1和TM-1表达变化以及RT-PCR观察肾脏Ang-1mRNA表达,并行相关性分析. 结果：糖尿病组4和8周时肾脏Ang-1mRNA表达显著上调, 24周时明显低于对照组;糖尿病组4～24周免疫组化显示肾小球Ang-1着染均显著高于对照组,峰值在4～8周,12周后逐渐下调;糖尿病组2～20周肾小球TM-1明显增强;Ang-1和TM-1呈正相关. 结论：糖尿病肾脏存在Ang-1和TM-1的异常改变,表现为早中期表达上调,后期表达下调,并且这种改变可能与糖尿病肾脏新生血管的生成有关.     

1-Naphthyl isocyanate and 1-naphthylamine as metabolites of 1-naphthylisothiocyanate

Abstract: The importance of the bioactivation of 1-naphthylisothiocyanate was studied. Forty minutes after 1-naphthylisothiocyanate administration to rats, bile was collected over a 2.5-h period; the liver was then excised and homogenized. 1-naphthylisothiocyanate and its metabolites in bile and liver of rats were identified and quantified using coupled gas chromatography-mass spectrometry. Three main compounds were found in all 1-naphthylisothiocyanate-treated animals. They were identified as 1-naphthyl isocyanate, 1-naphthylamine and the parent compound, 1-naphthylisothiocyanate. When rats were given cycloheximide, which attenuates 1-naphthylisothiocyanate toxicity, 30 min before 1-naphthylisothiocyanate (300 mg/kg), 1-naphthyl isocyanate concentration was significantly lower than in rats receiving only 1-naphthylisothiocyanate. The appearance of 1-naphthylamine was also inhibited by cycloheximide, although not to the same extent as 1-naphthyl isocyanate. On the other hand, phenobarbital, which potentiates 1-naphthylisothiocyanate hepatotoxicity, enhanced 1-naphthyl isocyanate and 1-naphthylamine formation. It is suggested that 1-naphthyl isocyanate, 1-naphthylamine and the highly reactive sulfur released from 1-naphthylisothiocyanate might be involved in the hepatotoxic effect of 1-naphthylisothiocyanate.     

Role of CYP2D6, CYP1A1, CYP2E1, GSTT1, and GSTM1 genes in the susceptibility to acute leukemias

Acute leukemias (ALs) are heterogeneous diseases. Functional polymorphisms in the genes encoding detoxification enzymes cause inter-individual differences, which contribute to leukemia susceptibility. The CYP2D6, CYP1A1, CYP2E1, GSTT1, and GSTM1 polymorphisms in ALL (n = 156) and AML (n = 94) patients and 140 healthy controls were genotyped by PCR and/or PCR-RFLP using blood or bone marrow samples. No association was observed between the GSTT1 gene deletion and patients (OR = 0.8, 95% CI = 0.4-1.7 for AMLs and OR = 0.9, 95% CI = 0.5-1.6 for ALLs). Patients with ALL and AML had a higher prevalence of the GSTM1 deletions compared to controls but only the difference among adult AML patients (OR = 2.1, 95% CI = 1.0-4.2) was statistically significant. The CYP2D6*3 variant allele frequency was lower in the overall acute leukemia patients (0.6%) compared to controls (P = 0.03). CYP2D6*1/*3 genotype frequency also showed a protective association in AML patients (OR = 0.09, 95% CI = 0.01-1.7; P = 0.04). We also found a risk association for CYP2E1*5 in ALL and AML (OR = 3.6, 95% CI = 1.4-9.4 and OR = 3.9, 95% CI = 1.4-10.5, respectively). No association was found for the studied CYP2D6*4, CYP1A1*2A, and GSTT1"null" variants and the risk of acute leuke-mia (ALL or AML). This case-control study suggests a contribution of CYP2E1, CYP2D6, and GSTM1 "null" variants to the development of acute leukemias.     

谷胱甘肽-S-转移酶M1和T1空白基因型与肝癌遗传易感性的研究

目的谷胱甘肽－Ｓ－转移酶Ｍ１和Ｔ１（ＧＳＴＭ１和ＧＳＴＴ１）空白基因型与肝癌遗传易感性的关系。方法应用多重ＰＣＲ技术检测６３例肝癌患者和８８例健康对照的ＧＳＴＭ１和ＧＳＴＴ１空白基因型。结果病例组ＧＳＴＭ１空白基因型的频率为５７．１％，对照组则为４２．０％，二者差异无显著性（χ２＝３．３５，Ｐ＝０．０６７），处于临界水平。ＯＲ值为１．８４（９５％ＣＩ＝０．９１～３．７３）。病例组ＧＳＴＴ１非空白基因型的频率为８７．３％，对照组则为６２．５％，二者差异有非常显著性（χ２＝１１．４２，Ｐ＝０．０００７２７４），ＯＲ值为４．１３（９５％ＣＩ＝１．６４～１０．７０）。叉生分析表明，ＧＳＴＴ１非空白基因型与肝癌的关联大于ＧＳＴＭ１空白基因型，两因素在肝癌发生中存在协同作用。结论具有ＧＳＴＭ１空白基因型和ＧＳＴＴ１非空白基因型的个体，患肝癌的危险性增加。     

A comparative study of the expression of Wnt-1, WISP-1, survivin and cyclin-D1 in colorectal carcinoma

Background and aims It is well accepted that activation of Wnt signalling occurs in colorectal carcinoma (CRC), but the correlation amongst the various proteins involved in primary tumours are still unclear. The expression of the inducer of this pathway, Wnt-1, and the downstream effectors, WISP-1, cyclin-D1 and survivin proteins, was compared in a series of CRC tissues with the apparently normal adjacent tissues to determine the relationship of these proteins.Patients and methods Formalin-fixed, paraffin-embedded tissue samples of 47 CRCs surgically resected at the Kuala Lumpur Hospital (KLH) between 1999 and 2000 were used. Immunohistochemical staining with monoclonal antibodies against cyclin-D1 and survivin and polyclonal antibodies against Wnt-1 and WISP-1 was performed. Results of immunohistochemistry were analysed for correlation between biomolecules and histopathological data of the patients.Results Of the 47 CRCs, 26 (55.3%), 15 (31.9%), 5 (10.6%) and 28 (59.6%) of the tumours exhibited positivity for Wnt-1, WISP-1, cyclin D1 and survivin, respectively. A lower percentage of the 40 apparently normal adjacent tissues were found to be positive for Wnt-1 (7, 17.5%), WISP-1 (±5, 12.5%) and survivin (13, 32.5%), but cyclin D1 was not detected in any of them. Interestingly, the total scores of Wnt-1, WISP-1 and survivin were significantly higher in CRC tissues (p=0.001, 0.034 and 0.044, respectively). Using the Spearman rank correlation test, a positive linear relationship was found between total Wnt-1 score with total WISP-1 score (rho=0.319, p=0.003) and total survivin score (rho=0.609, p=<0.001). The expression of WISP-1 in the CRC tissues was found to be positively correlated with patients older than 60 years old (p=0.011). In addition, nuclear cyclin-D1 expression was found to be associated with poorly differentiated CRC tissues (p<0.001, Table 5) and right-sided CRC tumour (p=0.019, Table 6). Total WISP-1 score was associated with well-differentiated CRC tissues (p=0.029).Conclusions Overexpression and interplay between Wnt-1, WISP-1, survivin and cyclin-D1 may play a role in tumorigenesis, possibly by promoting cell cycle checkpoint progression, accelerating cell growth and inhibiting apoptosis. Our data may provide useful information towards the search for potent therapeutic targets towards the development of novel treatment strategies for CRC.     

胃癌中ERCC1、XRCC1表达与奥沙利铂化疗疗效之间的关系

目的观察胃癌组织中ERCC1、XRCC1的表达变化,探讨其与奥沙利铂化疗疗效的关系。方法采用免疫组化SP法检测80例胃癌患者术后胃癌组织中ERCC1、XRCC1的表达水平,患者术后全部采用FLO-FOX化疗方案,并采用2χ检验、Log-rank分析和Cox风险模型分析ERCC1、XRCC1在胃癌中的表达及其对奥沙利铂化疗疗效的影响。结果胃癌组织中ERCC1、XRCC1阳性率分别是72.50%（58/80）、45.00%（36/80）。Cox比例风险模型分析显示,胃癌组织中ERCC1表达、XRCC1表达、组织学分型和有无脉管癌栓是影响患者预后的独立因素。结论胃癌组织中的ERCC1、XRCC1表达水平与奥沙利铂化疗疗效有关。     

空调空气滤网灰尘中尘螨变应原Der f1和Der p1基因的检测

目的应用PCR技术检测空调空气滤网灰尘中尘螨变应原Der f1和Der p1的基因。方法从深圳和北京地区分别收集20台、10台空调过滤网上的灰尘样品,分别提取其生物总基因组DNA作PCR模板,分别设计Der f1和Der p1各两套内外扩增引物分两步进行PCR,通过扩增出目的片段来检测空调空气滤网灰尘中尘螨变应原Der f1和Der p1基因片段,并以深层泥土DNA提取物为阴性对照和以培养的粉尘螨、屋尘螨基因组DNA提取物为阳性对照。PCR产物经电泳后切胶回收目的片段并克隆到T载体上,进行DNA序列分析并与Gen Bank进行同源性比较分析。结果深圳地区20台空调空气滤网上收集的灰尘中均含有粉尘螨和屋尘螨主要变应原Der f1和Der p1基因片段;北京地区10台空调空气滤网上收集的灰尘样品中,只有4份均含有Der f1和Der p1;它们扩增部分的序列与GenBank数据库里相应序列同源性为100%。从阴性对照提取物中未扩增得到目的变应原Der f1和Der p1基因片段,从阳性对照的DNA提取物中分别扩增得到目的变应原Der f1和Der p1基因片段。结论本研究首次应用分子生物学技术证实了空调空气滤网上的灰尘中存在尘螨主要变应原Der f1和Der p1基因,并提示深圳地区空调过滤网灰尘中尘螨可能比北京地区的多,从而为今后防治空调中尘螨引起的变态反应性疾病提供了依据。     

Endoscopic resection for T1a-MM and T1b-SM1 squamous cell carcinoma of the esophagus

In Japan, the first paper on endoscopic resection (ER) for squamous cell carcinoma (SCC) of the esophagus confined to the mucosa was reported as endoscopic mucosal resection (EMR) in 1988. Since publication of that article, ER has been recommended as the standard treatment for squamous and mucosal cancer of the esophagus. T1a-EP and T1a-LPM esophageal cancer seldom involves lymph node metastasis. However, in cases of T1a-MM and T1b-SM1 esophageal cancer with lymph node metastasis (10% to 30%), the indication of ER is limited. The risk factors for lymph node metastasis in T1a-MM and T1b-SM1 esophageal cancer were cleared by clinical and pathological studies. Endoscopic findings such as type 0–I or type 0–III, size of 50 mm or more, and pathological findings such as lymphatic permeation, venous permeation, poorly differentiated SCC and INFb or INFc were suggestive of high risk for lymph node metastasis. In addition, histopathological findings of small cancer nests, defined as “budding” or “droplet infiltration,” suggest frequent lymph node metastasis. In cases of T1a-MM and T1b-SM1 esophageal cancer with high risk of lymph node metastasis, adjuvant therapy including chemoradiotherapy and radical esophagectomy are recommended after ER. A recent advance in ER for esophageal cancer is the establishment of endoscopic submucosal dissection (ESD). It has allowed us to perform an en-block resection of a large mucosal lesion of the esophagus and detailed histopathological examination. However, ESD requires more difficult manipulation than EMR. The indication of EMR or ESD is sought.     

Slfn1通过下调Cyclin D1抑制内皮祖细胞的黏附功能

目的探讨睡眠因子1(Slfn1)对内皮祖细胞(EPC)黏附功能的影响。方法实验分为空白对照组(未给予任何处理的EPC,N-control组)、腺病毒阴性对照组(Ad-control组)、Slfn1腺病毒载体组(Ad-Slfn1组)、发夹状RNA阴性对照组(Sh RNA-control组)、发夹状RNA Slfn1干扰组(Sh RNA-Slfn1组)。分离培养大鼠骨髓源性EPC,用Sh RNA-control质粒、Ad-Slfn1及相应的对照质粒分别转染EPC,采用Western blot检测细胞Slfn1及Cyclin D1表达,将EPC接种在预先铺好纤维连接蛋白的培养板中,观察其黏附功能。用流式细胞仪检测细胞周期。结果Sh RNA-Slfn1组Slfn1蛋白的表达明显低于Sh RNA-control组,Ad-Slfn1组Slfn1蛋白的表达明显高于Ad-control组,说明转染有效。用Sh RNA-Slfn1减弱EPC Slfn1基因的表达明显增强EPC的黏附能力,过表达Slfn1基因则明显抑制EPC的黏附能力。细胞周期检查结果显示,降低EPC Slfn1基因的表达,EPC的细胞周期进入到S期细胞明显增多,过表达Slfn1基因使EPC的细胞周期停止在G1期。Western blot检测结果发现,Sh RNA-Slfn1组Cyclin D1的蛋白表达明显高于Sh RNA-control组,而Ad-Slfn1组Cyclin D1的蛋白表达则明显低于Ad-control组。结论 Slfn1通过下游靶点Cyclin D1负性调控EPC的黏附功能。