The role of TNF-alpha in myelodysplastic syndrome: immunoserologic and immunohistochemical studies]

TNF alpha is a highly active cytokine which plays an important role in the regulation of apoptotic cell death, a mechanism involved in the pathophysiology of myelodysplastic syndrome (MDS). In this study we investigated the expression of TNF alpha on the bone marrow trephine biopsies by immunohistochemical method and the TNF alpha production of peripheral blood mononuclear cells by ELISA method in 15 patients affected by MDS. Five of seven patients without excess of blasts showed high or intermediate TNF alpha expression in the bone marrow biopsies, whereas two patients with excess of blasts were negative and one had low expression. The five CMML patients revealed low or intermediate expression. The production of TNF alpha by the PBMC was analysed in 10 patients, four patients with RA and two with CMML produced higher level of TNF alpha which increased after stimulation with phorbol myristic acetate, but none of the RAEB patients revealed increase in TNF alpha production. In conclusion we suppose that increased TNF alpha expression and production by PBMC may be a further indirect evidence of the role of increased apoptosis in low risk MDS patients, in the course of progression the cytokine expression and production decreases.     

VEGF-C和FLT-4在乳腺癌中的表达及与淋巴结转移的相关性

目的:探讨人类乳腺癌血清中VEGF-C和FLT-4的表达与乳腺癌淋巴结转移的关系。方法:采用ELISA方法对75例乳腺癌患者和30例乳腺良性肿瘤患者的血清进行VEGF-C和FLT-4水平的检测。结果:乳腺癌组VEGF-C表达水平为(788.13±40.09)pg/ml,高于乳腺良性肿瘤组的(317.35±43.26)pg/ml,乳腺癌组FLT-4水平为(564.39±67.06)pg/ml,高于乳腺良性肿瘤组的(353.62±58.47)pg/ml,差异均有统计学意义(P<0.05);有淋巴结转移乳腺癌患者VEGF-C浓度为(1054.26±215.48)pg/ml,FLT-4浓度为(730.45±142.87)pg/ml,高于无淋巴结转移乳腺癌患者,差异有统计学意义(P<0.05);手术后2周乳腺癌患者VEGF-C和FLT-4浓度分别为(362.41±97.65)pg/ml、(324.58±76.54)pg/ml,低于术前水平,差异有统计学意义(P<0.05)。结论:检测VEGF-C和FLT-4水平可以辅助判断乳腺癌淋巴结转移情况。     

Cytokines detectable in saliva of children as appropriate markers of local immunity of the oral cavity--an approach for the use in air pollution studies.

The objective of this study was the detection of proinflammatory markers in saliva to be involved in local immunity of the oral cavity. Therefore saliva of 167 schoolchildren aged 8-10 years were investigated for the presence of interleukin-8 (IL-8), tumour necrosis factor alpha (TNF alpha) and soluble tumour necrosis factor receptor type II (sTNFRII). In saliva of schoolchildren sufficient quantities of IL-8 (302.3-4208.6 pg/ml), TNF alpha (0.3-40.6 pg/ml) and sTNFRII (17.6-931.3 pg/ml) were detectable. IL-8, TNF alpha and sTNFRII revealed significant correlations with each other. Results suggest an immunoregulatory mechanism of IL-8, TNF alpha and TNF-receptor to be of special concern in host defence as well as in maintaining homeostasis of local immunity within the oral cavity. Saliva provides an ideal medium for the detection of proinflammatory markers of the oral cavity with respect to mucosal and granulotype origin and may be employed in air pollution epidemiology, especially with regard to children.     

Serum osteoprotegerin and RANKL levels in chronic alcoholic liver disease

OBJECTIVES: Osteoprotegerin (OPG) is a decoy receptor that binds RANK-ligand (RANKL) and prevents osteoclast activation. Oestrogens, androgens, corticosteroids, parathyroid hormone (PTH), vitamin D, and several cytokines exert their effects on bone modulating the OPG/RANKL system. Since these substances become altered in chronic alcoholic liver disease, we investigated the OPG/RANKL system in alcoholic liver disease, its relation with bone mineral density (BMD) and with several hormones and cytokines. METHODS: Serum OPG, RANKL, C-terminal cross-linking telopeptide of type 1 collagen, osteocalcin, insulin-like growth factor 1 (IGF-1), 1,25 dihydroxyvitamin D, IL-6, tumour necrosis factor (TNF)-alpha, PTH, estradiol, free testosterone and corticosterone were measured in 77 male alcoholic patients, 25 of them cirrhotics. All these patients underwent assessment of BMD at lumbar spine and left hip by a Hologic QDR-2000 (Waltham, MA) bone densitometer. Nineteen non-drinkers male sanitary workers of similar age served as controls. RESULTS: Serum OPG levels were higher in patients (12.66 +/- 6.44 pmol/l) than in controls (6.59 +/- 1.58 pml/l, P < 0.005), especially in cirrhotics (15.97 +/- 7.03 pmol/l) vs non-cirrhotics (10.96 +/- 5.45 pmol/l, P < 0.001). Patients also showed higher telopeptide levels (0.60 +/- 0.36 vs 0.20 +/- 0.10 nmol/100 ml, P < 0.001), less IGF-1 [median = 192, interquartile range (IQR) = 46.7-175.99 ng/ml vs 150, IQR = 118.8-239.4 ng/ml, P < 0.001], vitamin D (25.5, IQR = 18.25-35 pg/ml vs 77.89, IQR = 57.48-98.53 pg/ml, P < 0.001) and osteocalcin (1.8, IQR = 1-3.6 ng/ml vs 6.04, IQR = 4.63-8.20 ng/ml, P < 0.001) than controls, but no differences in PTH and RANKL. Patients also showed lower Z-scores than controls at trochanter (-0.36 +/- 1.10 vs 0.26 +/- 0.87 in controls, P = 0.026), intertrochantereal area (-0.56 +/- 1.16 vs 0.46 +/- 1.01, P = 0.001), and total hip (-0.44 +/- 1.12 vs 0.42 +/- 1, P = 0.003). TNF-alpha levels were higher in patients (7.40, IQR = 4.30-17.80 pg/ml) than in controls (5.10, IQR = 4.40-8 pg/ml, P = 0.009), especially in cirrhotics (median = 13.90, IR = 6.10-21.10 pg/ml). OPG levels showed strong correlations with TNF-alpha (rho = 0.57, P < 0.001) and IL-6 (r = 0.62, P < 0.001), but not with BMD. Estradiol levels (31.83 +/- 13.11 pg/ml) were higher and free testosterone lower (13.62 +/- 11.96 pg/ml) in patients than in controls (20.36 +/- 3.08 and 18.19 +/- 4.68 pg/ml, respectively, P < 0.001 in both cases). CONCLUSION: OPG is raised in alcoholics, especially in cirrhotics, showing no relationship with decreased BMD. Also, raised TNF and IL-6 were observed, and were strongly, directly related with OPG levels. Since TNF and IL-6 enhance bone resorption, their relation with OPG suggests a protective effect of raised OPG on bone loss.     

胃癌患者血清miR-204、HSP-70及IL-2与Hp感染及病情关系研究

目的探讨胃癌患者血清中微小RNA-204(MicroRNA-204,miR-204)、热休克蛋白-70(Heat shock protein-70,HSP-70)及白细胞介素-2(Interleukin-2,IL-2)的变化与幽门螺杆菌(Helicobacter pylori,Hp)感染、TNM分期及淋巴结转移的关系。方法选取2015年1月-2018年10月郑州大学附属肿瘤医院经病理学或胃镜确诊的初诊胃癌患者96例作为胃癌组、胃炎患者96例作为对照组,检测对比两组的血清miR-204、HSP-70及IL-2与Hp感染水平,并按照Hp感染结果、TNM分期、淋巴结转移结果将胃癌组进行分层分析。结果胃癌组的血清HSP-70为(2.33±0.76)pg/ml高于对照组(1.16±0.40)pg/ml(P<0.05);胃癌组的血清miR-204(0.462±0.117)、IL-2(2.26±0.78)ng/ml低于对照组miR-204(1.330±0.205)、IL-2(3.95±0.92)ng/ml(P<0.05);Ⅰ期和Ⅱ期胃癌患者的血清HSP-70水平低于Ⅲ期和Ⅳ期,血清miR-204、IL-2水平高于Ⅲ期和Ⅳ期(P<0.05);Hp感染阳性胃癌患者的血清HSP-70水平高于阴性患者,血清miR-204、IL-2水平低于阴性患者(P<0.05)。结论胃癌患者血清HSP-70、miR-204、IL-2水平异常表达与TNM分期、淋巴结转移及Hp感染有一定的关系。     

LIF and TNF alpha concentrations in embryo culture media are predictive for embryo implantation in IVF

ObjectiveThere is strong evidence that the cytokines leucemia inhibitory factor (LIF) and tumor necrosis factor (TNF) alpha are related to embryo development and implantation. The aim of this study was to determine the levels of LIF and TNF alpha in embryo culture media and to assess its relationship to the outcome of in-vitro fertilization and embryo transfer.MethodsA total of 99 patients were included in this prospective trial and underwent either IVF or ICSI procedure. A total of 865 oocytes were collected. Embryos were cultured in sequential media until day 5. A standardized morphology evaluation of all embryos, including a detailed pronuclear scoring, was performed daily during this period followed by the replacement of one or two selected embryos. Collected embryo culture fluids of days 3 and 5 were analysed for LIF and TNF alpha on days 3 and 5.ResultsMean TNF alpha concentration in culture media on day 3 was 0.54 and 0.37 pg/mL on day 5 and was significantly lower in women conceiving than in not conceiving (0.43 pg/mL versus 0.59 pg/mL on day 3). Mean LIF concentration on day 3 was 31.5 pg/mL and 35.5 pg/mL on day 5 and was significantly higher in women conceiving (56.2 pg/mL versus 22.2 pg/mL on day 3).ConclusionsThe results indicate that LIF could have a function in early embryogenesis and as a factor required for embryo implantation. High TNF alpha concentrations seem to be predictive of implantation failure.     

肺癌病人外周血NK细胞与TNF检测及其临床意义

为探讨肺癌患者体内肿瘤坏死因子（TNF）与自然杀伤（NK）细胞活性水平及影响二者活性的临床因素。采用外周血诱生TNF测定法检测TNF活性;应用荧光检测法分析细胞毒性效应DNA以观察NK细胞活性。结果发现肺癌患者NK细胞活性显著低于正常人和非癌胸病病人,并随病期进展、肿瘤增大及淋巴结转移而加重,不受病理学类型影响。TNF活性水平显著高于非癌胸病人与正常人,而与病期、肿瘤大小、淋巴结转移与否及病理学类型无关。结果认为肺癌病人体内细胞免疫功能处于严重失衡状态,表现为NK细胞活性下降,全血诱生TNF活性呈高水平状态,检测二者活性可为肺癌病人的综合治疗提供理论依据。     

Diagnosis and treatment of malignant histiocytosis

Of twelve patients with malignant histiocytosis admitted between 1974 and 1987, clinical symptoms, diagnostic procedures and the course of the disease were retrospectively evaluated. Predominant findings at physical examination were fever (11/12), splenomegaly (12/12), hepatomegaly (8/12), and lymphadenopathy (8/12). Laboratory findings included anaemia, leukocytopenia, thrombocytopenia, high lactate dehydrogenase, and jaundice. Positive diagnostic procedures included biopsies or aspirates of bone marrow (11/12), spleen (6/10), liver (7/9), lymph node (4/4), skin (1/2), lung (1/1) and blood (2/12). In seven patients treated with combination chemotherapy an average survival of 540 days was observed, while two long-term disease-free survivals were accomplished.     

鼻咽癌患者医院感染的细针抽吸细胞学诊断研究

目的探讨鼻咽癌患者医院感染的细针抽吸细胞学(FNAC)诊断特点. 方法对 280例住院治疗的鼻咽癌患者进行细针抽吸细胞学检查. 结果脓肿17例,占6.1%;淋巴结炎70例,占25.0%;转移癌 155例,占55.4%;转移癌伴感染38例,占13.6%;有炎症症状的,部分合并有癌转移,无炎症症状的,部分为炎症,部分为转移癌,两者有交叉;FNAC诊断鼻咽癌医院感染率为7.5%. 结论鼻咽癌患者是医院感染的高危人群,不能根据有无炎症表现来诊断医院感染;FNAC检查是诊断鼻咽癌患者医院感染快速准确的方法.     

Kala-azar: a comparative study of parasitological methods and the direct agglutination test in diagnosis.

In a comparative study 88 patients were diagnosed as suffering from kala-azar (visceral leishmaniasis) using 3 parasitological methods simultaneously. Splenomegaly was absent in 4 cases. In 84 patients with splenomegaly, splenic aspiration appeared to be the most sensitive method (96.4%), followed by bone marrow aspiration (70.2%) and lymph node aspiration (58.3%). There was no relation between titres in the direct agglutination test and parasite load as determined by the number of parasitological methods which were positive or parasite density in splenic aspirates. Splenic aspiration and bone marrow aspiration were compared as an assessment of cure in kala-azar. In 6 (13%) of 46 patients tested, parasites were found, all by splenic aspiration. Bone marrow showed parasites in one of these. The literature with regard to parasitological investigations before and after treatment is reviewed.     

高功率微波对大鼠免疫组织活性氧水平的影响

目的观察高功率微波辐照对大鼠免疫组织细胞内活性氧水平的影响。方法采用DCFH-DA分子探针结合流式细胞仪检测大鼠免疫组织细胞内经0、10、30、50mW/cm2微波辐照后不同时间活性氧水平的变化。结果①骨髓、淋巴结在0～30mW/cm2范围内活性氧水平出现规律性增高,在50mW/cm2时有所降低;脾脏在0～50mW/cm2范围内呈剂量依赖性增高;而胸腺组织虽有增高但未见明显的量效关系。②照后1d活性氧水平升高最为显著,3d出现明显降低,除骨髓高于对照组外,脾脏、淋巴结基本恢复正常。7d时全部恢复到对照水平。结论微波辐照可诱导大鼠免疫组织细胞内活性氧水平升高,在一定剂量范围内呈较好的量效和时效关系。     

Six cases of suppurative lymphadenitis caused by Burkholderia pseudomallei infection

Melioidosis, an infection caused by Burkholderia pseudomallei, is endemic in Southeast Asia and northern Australia. It can have various presentations, ranging from acute septicaemia to chronic localized infection. Uncomplicated, localized infection usually involves skin or subcutaneous tissues. Suppurative lymphadenitis caused by melioidosis has been rarely encountered by clinicians practicing in endemic areas. We encountered six cases of suppurative lymphadenitis caused by Burkholderia pseudomallei in adults who were admitted to hospital in Singapore from 1997 to 2000. The most striking difference between these patients and cases reported previously was the pattern of the lymph node involvement. In the majority of previously described patients the infected lymph nodes were in the head and neck region. By contrast, four patients in our study presented with unilateral, inguinal lymphadenitis. Another two patients presented with mediastinal lymphadenitis and prolonged fever. All patients had prompt and sustained response to therapy. Melioidosis should be considered in the differential diagnosis of suppurative, regional lymphadenitis, especially in patients who travelled to, or stayed in, an endemic area.     

Place de la ponction à l’aiguille fine du ganglion lymphatique dans le diagnostic d’adénopathies mycobactériennes au Mali

Objective: The relative lack of well-equipped pathology laboratories in areas of high tuberculosis prevalence can result in delayed or misdiagnosis of mycobacterial lymphadenitis. The aim of our study was to define the suitability of fine needle aspiration from lymph node to diagnose mycobacterial lymphadenitis in adults.Population: From June 1997 to April 1999, 51 patients with the diagnosis of mycobacterial lymphadenitis were admitted to two medical units in Bamako (Mali).Results: Ziehl–Neelsen staining was positive in 29 cases and 61.9% of these correlated to cytology results. Acid-fast bacilli were more frequent in lymph node aspiration than in sputum. Lymph node cytology and bacilloscopy were three to six times faster and cheaper than histology.Conclusion: Fine needle aspiration should be performed systematically for bacilloscopy and cytology in any adult with lymphadenitis in countries where HIV and tuberculosis are common.     

儿童亚急性坏死性淋巴结炎临床病理分析

目的:探讨儿童亚急性坏死性淋巴结炎(subacute necrotizing iymphadenitis)的临床病理特点。方法:回顾性分析19例儿童亚急性坏死性淋巴结炎病例的临床资料,全部病例切片进行组织学观察,并行免疫组化染色,随访全部病例。结果:19例中男性14例,女性5例,平均年龄7.3岁,临床主要表现为发热、颈淋巴结肿大和白细胞减少,抗生素治疗无效。组织学显示淋巴结内出现程度不同的碎片状坏死,伴有多种形态的组织细胞增生,坏死灶边缘可见浆样单核细胞、多形核细胞及免疫母细胞,无或很少有中性粒细胞浸润。随访5月~3年,全部存活。结论:儿童亚急性坏死性淋巴结炎是一种良性自限性疾病,具有特殊的临床表现和独特病理特点;掌握其临床和病理形态学特点,有助于与其他病变相鉴别。     

Visceral leishmaniasis in the Sudan: comparative parasitological methods of diagnosis

Patients with suspected kala-azar had aspirations of spleen, lymph node and bone marrow performed to compare the relative merit of each procedure. Splenic aspiration remains the method most likely to provide microscopic proof of leishmanial infection (18 of 19 samples) and was the only site positive in 5 patients. Lymph node aspirates contained parasites in 20 of 29 patients, whereas bone marrow aspirates provided the diagnosis in 18 of 28. Therefore, lymph node aspiration, with its minimal morbidity, is indicated as the primary diagnostic method in patients in the Sudan with suspected kala-azar. If negative, splenic aspiration should be performed.     

The relationship between body mass index and a plasma lipid peroxidation biomarker in an older, healthy Asian community

PURPOSE: To examine the association between body mass index (BMI) and the plasma level of a lipid peroxidation biomarker in a large sample of elderly healthy Asian population. This cross-sectional study included 1150 community-dwelling Japanese aged 70 years or older in 2002. METHODS: We measured the lipid peroxidation biomarker 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) using the ELISA method. We also measured the weight and height and calculated the BMI as weight (kg)/height (m)2. RESULTS: After adjustment for potential confounders, the mean +/- SE plasma 8-iso-PGF(2alpha) level was significantly higher in subjects with higher BMI: 21.1 +/- 0.8 pg/ml in those with BMI of 30.0 or more; 20.5 +/- 0.3 pg/ml in those with BMI between 25.0 and 29.9; 20.0 +/- 0.2 pg/ml in those with BMI between 18.5 and 24.9; and 19.0 +/- 0.7 pg/ml in those with BMI of less than 18.5 (p for trend = 0.011). CONCLUSIONS: Our results demonstrated that in the healthy Asian population, there was a modest but significant relationship between BMI and the plasma lipid peroxidation level.     

高频彩色多普勒在小儿肠系膜淋巴结炎诊断中的应用

目的探讨高频彩色多普勒在小儿肠系膜淋巴结炎诊断中的应用价值。方法选择101例肠系膜淋巴结炎患儿(观察组)和100例健康体检儿童(正常组),使用PHILIPS-IU22彩色超声诊断仪检查,比较两组检出淋巴结分布、大小,并观察组淋巴结回声性质。结果观察组检测出淋巴结位于右下腹和脐周者多于正常组(p<0.05),观察组淋巴结横径为(6.6±1.4)mm,纵径为(14.1±5.0)mm,观察组低回声型73例,等回声型20例,混合回声型8例。结论高频彩色多普勒是诊断小儿肠系膜淋巴结炎的首选检查方法,对临床诊断治疗有重要意义。     

Clinical thinking and decision making in practice. A patient with anal cancer and hypercalcemia

A 57-year-old male patient, recently known with an anal carcinoma with inguinal lymph node involvement, was admitted because of anorexia, nausea, vomiting and constipation. On physical examination the patient was dehydrated, and a systolic murmur, grade III/VI, punctum maximum apex cordis, was heard. Serum calcium was raised (4.50 mmol/l), as was the serum creatinine (328 mumol/l). Both values had been normal 14 days before admission. Serum parathormone was suppressed. A bone scan did not reveal evident lesions in the skeleton. FDG-PET scan showed uptake of the tracer into the bone marrow. A bone biopsy showed metastasis of a squamous cell carcinoma. Shortly after that the patient died. Hypercalcaemia is associated with cancer. Colorectal/anal carcinomas have a low incidence of hypercalcaemia. The prognosis of patients with cancer associated with hypercalcaemia is poor.     

Intestinal FABP2 A54T polymorphism: association with insulin resistance and obesity in women

OBJECTIVE: To assess the association between the Ala54Thr genetic polymorphism of the fatty acid-binding protein 2 (FABP2) gene with insulin resistance and obesity. RESEARCH METHODS AND PROCEDURES: According to a sampling scheme based on BMI, 33 adult obese women (BMI > or = 30) and 30 adult normal-weight women (BMI > 18.5 and < 25 kg/m(2)) were recruited for this study. Women with chronic inflammatory diseases or acute pathology were excluded. Glucose, insulin, leptin, lipids, and tumor necrosis factor alpha (TNF alpha) were measured in fasting plasma samples. Insulin resistance was estimated through the homeostasis model assessment for insulin resistance method. The Ala54Thr allelic variant was determined by polymerase chain reaction, followed by restriction fragment-length polymorphism analysis. RESULTS: The Thr54 allele was more frequent in obese than in nonobese women (47.0% vs. 31.7; p = 0.08). Among obese women, higher TNF alpha concentrations were found when comparing the Thr54/Thr54 genotype (30.0 +/- 7.1 pg/mL) with either the Ala54/Thr54 genotype (21.2 +/- 8.4 pg/mL) or the Ala54/Ala44 genotype (20.1 +/- 7.0 pg/mL) (p < 0.05). In addition, higher fasting plasma insulin and leptin levels were found among Thr54/Thr54 homozygotes compared with the other genotypes (p < 0.05). DISCUSSION: Our results suggest that the Ala54Thr polymorphism of the FABP2 gene is associated with obesity and insulin resistance. The effect of this polymorphism might be mediated by elevated production of TNF alpha.     

血清中巨噬细胞移动抑制因子表达与大肠癌的分期及淋巴结转移相关性研究

目的研究大肠癌患者血清中巨噬细胞移动抑制因子（MIF）表达水平与临床特征的关系。方法利用酶联免疫吸附的方法（ELISA）检测75例大肠癌患者（35例原发性大肠癌及40例有淋巴结转移的大肠癌）及40例非癌对照人群血清中MIF的表达水平,探讨MIF与临床特征的关系。结果与正常人群血清中MIF表达水平相比（平均值13．6ng／ml）,大肠癌患者血清中MIF表达水平明显增高（平均值31．2ng／ml）,且表达水平增高与临床进展分期（P〈0．05）及淋巴结转移相关（P〈O．05）。结论MIF在血清中表达增高可能促进了大肠癌的发病过程,并与大肠癌的分期及淋巴结转移密切相关。