卵巢癌患者血清VEGF、CA125水平的变化及意义

目的:观察卵巢癌患者血清血管内皮细胞生长因子(VEGF)与肿瘤标志物CA125水平变化及临床意义。方法:采用酶联免疫吸附法(ELISA)与微粒子酶免分析技术(MEI A),检测31例卵巢良性肿瘤和64例卵巢癌患者及44例健康女性血清VEGF与CA125的含量,并对26例卵巢癌患者术后VEGF和CA125进行随访监测。结果:卵巢癌患者血清VEGF与CA125水平明显高于良性卵巢肿瘤及正常对照组(P<0.01),晚期(Ⅲ~Ⅳ期)卵巢癌患者显著高于早期(Ⅰ~Ⅱ期)(P<0.01)。26例卵巢癌患者术后血清中VEGF、CA125水平明显降低(P<0.01)。结论:VEGF、CA125与卵巢癌的发生及发展有密切关系,检测其水平变化对判断卵巢癌的恶性程度及预后,提高临床诊断水平有重要价值。     

Clinical Significance of Detecting Serum HE4, CA125 and CA724 Levels in Diagnoses of Ovarian Malignancies

目的 通过检测卵巢恶性肿瘤患者血清人附睾蛋白4(HE4)、CA125和CA724水平,探讨这三项检测在卵巢恶性肿瘤诊断中的临床价值.方法 采用电化学发光免疫法(ECL)检测CA125和CA724水平,以ELISA法检测HE4水平.测定36例卵巢恶性肿瘤组患者、59例卵巢良性疾病患者及70名健康体检人群血清三项水平并进行比较.结果 卵巢恶性肿瘤组患者血清HE4、CA125和CA724水平显著高于良性疾病组和健康体检组(P＜0.05),其中良性疾病组CA125和CA724水平高于健康体检组(P＜0.05),但是良性疾病组HE4水平与健康体检组比较差异无统计学意义(P＞0.05);卵巢恶性肿瘤组患者血清HE4、CA125、CA724单独检测的灵敏度分别为69.4％、83.3％、58.3％,而这三项联合检测的灵敏度为91.7％,明显高于三项单独检测(P＜0.05).当以卵巢良性疾病组作为参照人群时,HE4、CA125、CA724单独检测的特异性分别为96.6％、62.7％、81.4％,而这三项联合检测的特异性为61.0％.结论 HE4在诊断卵巢恶性肿瘤上具有高度特异性的肿瘤标志物,区分良性或恶性肿瘤时应选择HE4检测;卵巢肿瘤疾病的筛查是可选择HE4、CA125、CA724和三项联合检测以提高诊断的敏感性.     

血清HE4、CA125和CA724检测在卵巢恶性肿瘤诊断中的应用

目的通过检测卵巢恶性肿瘤患者血清人附睾蛋白4(HE4)、CA125和CA724水平,探讨这三项检测在卵巢恶性肿瘤诊断中的临床价值。方法采用电化学发光免疫法(ECL)检测CA125和CA724水平,以ELISA法检测HE4水平。测定36例卵巢恶性肿瘤组患者、59例卵巢良性疾病患者及70名健康体检人群血清三项水平并进行比较。结果卵巢恶性肿瘤组患者血清HE4、CA125和CA724水平显著高于良性疾病组和健康体检组(P0.05),其中良性疾病组CA125和CA724水平高于健康体检组(P0.05),但是良性疾病组HE4水平与健康体检组比较差异无统计学意义(P0.05);卵巢恶性肿瘤组患者血清HE4、CA125、CA724单独检测的灵敏度分别为69.4%、83.3%、58.3%,而这三项联合检测的灵敏度为91.7%,明显高于三项单独检测(P0.05)。当以卵巢良性疾病组作为参照人群时,HE4、CA125、CA724单独检测的特异性分别为96.6%、62.7%、81.4%,而这三项联合检测的特异性为61.0%。结论 HE4在诊断卵巢恶性肿瘤上具有高度特异性的肿瘤标志物,区分良性或恶性肿瘤时应选择HE4检测;卵巢肿瘤疾病的筛查是可选择HE4、CA125、CA724和三项联合检测以提高诊断的敏感性。     

血清AFP、CEA、CA50、CA19.9、CA125联合检测对卵巢恶性肿瘤的诊断及复发的价值

目的探讨血液中AFP、CEA、CA50、CA19.9、CA125含量的联合检测对恶性卵巢肿瘤的诊断及预后的临床价值.方法采用放免法(RIA)测定138例患者治疗前后的血清5项指标含量(恶性卵巢肿瘤48例、卵巢良性肿瘤55例及良性包块35例).结果联合检测恶性卵巢肿瘤性率95.8%(46/48),明显高于卵巢良性肿瘤、良性包块及CA125单项检测阳性率(p<0.05).卵巢良性肿瘤及良性包块的联合检测阳性率分别为12.7%(7/55)和77.1%(27/35),与CA125单项检测率无差异(p>0.05).非上皮性肿瘤联合检测阳性率明显高于CA125阳性率(p<0.05).恶性卵巢肿瘤Ⅰ期～Ⅱ期联合检测阳性率明显高于CA125阳性率无差异(p<0.05).Ⅲ期～Ⅳ期CA125阳性率与联合检测阳性率无差异(p>0.05).48例恶性卵巢肿瘤经化疗或手术治疗后,证实复发有10例.联合检测阳性9例, CA125阳性5例(p<0.05).结论上述五项指标联合检测对恶性卵巢肿瘤的诊断及预后有较高的临床价值.     

肺癌患者血清CEA、NSE、CA125、VEGF检测的临床意义

目的:探讨了血清CEA、NSE、CA125、VEGF水平在肺癌患者中的变化.方法:分别应用放射免疫分析和ELISA法对33例肺癌患者进行了血清CEA、NSE、CA125和VEGF水平测定,并以30名正常健康人作比较.结果:肺癌患者血清CEA、NSE、CA125和VEGF水平非常显著地高于正常人组(P＜0.01),且CEA、NSE、CA125和VEGF呈明显正相关(r=0.6105、0.6283、0.6318,P＜0.01).结论:检测肺癌患者血清CEA、NSE、CA125和VEGF水平的变化对了解病情、指导临床实践均具有重要的临床价值.     

血清AFP、CEA、CA50、CAl9．9、CAl25联合检测对卵巢恶性肿瘤的诊断及复发的价值

目的 探讨血液中AFP、CEA、CA50、CA19.9、CA125含量的联合检测对恶性卵巢肿瘤的诊断及预后的临床价值.方法 采用放免法(RIA)测定138例患者治疗前后的血清5项指标含量(恶性卵巢肿瘤48例、卵巢良性肿瘤55例及良性包块35例).结果 联合检测恶性卵巢肿瘤性率95.8％(46/48),明显高于卵巢良性肿瘤、良性包块及CA125单项检测阳性率(p<0.05).卵巢良性肿瘤及良性包块的联合检测阳性率分别为12.7％(7/55)和77.1％(27/35),与CA125单项检测率无差异(P>0.05).非上皮性肿瘤联合检测阳性率明显高于CA125阳性率(p<0.05).恶性卵巢肿瘤I期-Ⅱ期联合检测阳性率明显高于CA125阳性率无差异(p<0.05).Ⅲ期-Ⅳ期CA125阳性率与联合检测阳性率无差异(p>0.05).48例恶性卵巢肿瘤经化疗或手术治疗后,证实复发有10例.联合检测阳性9例,CA125阳性5例(p(0.05).结论 上述五项指标联合检测对恶性卵巢肿瘤的诊断及预后有较高的临床价值.     

卵巢上皮性肿瘤患者血清VEGF与血清肿瘤标志物HE4、CA199的相关性分析

目的:探讨卵巢上皮性肿瘤患者血管内皮生长因子(Vascular endothelial growth factor,VEGF)基因突变与血清肿瘤标志物人附睾蛋白4(Humanepididymisprotein4,HE4)、糖类抗原199(Carbohydrate antigen199,CA199)的相关性.方法:回顾性分析选取我院2020年1月-2022年1月收治卵巢上皮性肿瘤患者96例患者作为研究对象,根据病理检查结果将卵巢上皮性肿瘤分为恶性组49例,良性组47例.同时,选取本院同期体检健康妇女45例作为对照组.采集三组人员清晨空腹静脉血,检测血清VEGF、HE4及A199水平,并评估在卵巢上皮性肿瘤患者VEGF表达与血清肿瘤标志物HE4、CA199的相关性及预测价值.结果:恶性组血清VEGF、HE4及CA199水平高于良性组、对照组.良性组血清VEGF、HE4及CA199水平高于对照组,三组差异比较具有统计学意义(P<0.05).血清VEGF与HE4呈正相关性(r=0.459,P<0.001),血清VEGF与CA199呈正相关性(r=0.406,P<0.001).根据ROC曲线获得,血清VEGF、HE4及CA199水平敏感度分别为83.7％,75.5％,75.57％,特异度分别为87.0％,84.2％,79.3％,准确度分别为85.4％,79.9％,77.4％,表明三者的敏感度、特异度及准确度均较高,且血清VEGF各项指标最高.结论:卵巢上皮性肿瘤患者血清VEGF与血清肿瘤标志物HE4、CA199呈正相关,血清VEGF、HE4及CA199水平异常升高提示患卵巢上皮性恶性肿瘤的风险增高,且对于卵巢上皮性肿瘤预后具有一定预测价值.     

尿精眯与血清CA125联合检测诊断卵巢恶性肿瘤的价值

探讨尿精眯(SPD)与血清CA125联合检测对卵巢恶性肿瘤的诊断价值.采用聚酰胺薄膜层析法分别测定20名对照组和47例妇科盆腔肿块患者尿SPD水平,同时用化学发光免疫法检测两组患者的血清CA125水平.结果表明,卵巢恶性肿瘤组患者尿SPD和血清CA125水平(679.49±368.39 μg/mg肌酐,251.23±172.48 U/L)明显高于对照组(218.76±88.35 μg/mg,13.96±12.07 U/L)和卵巢良性肿瘤组患者(204.62±85.26 μg/mg肌酐,25.29±31.6 3U/L).两标记物对卵巢恶性肿瘤的灵敏度分别为80.95%和71.43%,若二者联合灵敏度可高达90.48%.尿SPD和血清CA125联合检测可提高卵巢恶性肿瘤的诊断准确率.     

恶性肿瘤患者血清VEGF、IL-8水平与化疗疗效关系的研究

探讨血管内皮生长因子(VEGF)、白介素-8(IL-8)水平与恶性肿瘤临床分期、组织学分型等因素及化疗近期疗效之间的关系.采用定量ELISA方法分别检测53例恶性肿瘤患者化疗前血清VEGF与IL-8水平,其中25例经正规化疗后复查上述指标;10例对照为健康志愿者;同期还有CEA、CA125及CYFRA21-1或CEA及CA19-9两种肿瘤标志物组合检测.恶性肿瘤组化疗前血清VEGF及IL-8含量均明显高于对照组(P＜ 0.01),且随临床分期的进展而上升,但与肿瘤组织学类型及性别无明显相关性.化疗后血清VEGF及IL-8均显著下降(P＜ 0.01).VEGF、IL-8诊断肿瘤的阳性率高于瘤标组合并随临床分期进展而上升,联合检测可提高阳性率.VEGF和IL-8是肿瘤的发生、发展和转移的有效生物学指标.动态检测VEGF和IL-8化疗前后浓度变化能在一定程度上反映化疗近期疗效,可为临床选择治疗措施及判断预后提供有效帮助.     

175例卵巢肿瘤患者血清肿瘤标志物水平分析

目的:分析卵巢肿瘤患者血清肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、糖链抗原125(CA125)、糖链抗原199(CA199)和附睾蛋白4(HE4)的水平及临床价值。方法:选取武汉大学人民医院2015-01—2018-10收治175例卵巢肿瘤患者的临床资料,依据术后组织病理报告结果,将患者分为卵巢癌组(n=88)和卵巢良性肿瘤组(n=87)。选取同期本院体检中心体检的健康女性41例为对照组。检测各组血清AFP、CA125、CA199、CEA和HE4水平并比较各组各指标差异。结果:与对照组和卵巢良性肿瘤组相比,卵巢癌组患者血清AFP、CEA、CA125、CA199和HE4水平均升高(P0.05或P0.01)。与对照组相比,卵巢良性肿瘤组血清CA125和CA199水平升高(P0.05或P0.01),AFP、CEA及HE4水平差异无统计学意义(P0.05)。相关性分析结果显示卵巢癌患者CA125与HE4水平呈正相关关系(r=0.237,P0.05)。结论:卵巢癌患者血清AFP、CEA、CA125、CA199和HE4水平均升高,且CA125与HE4水平呈明显正相关,二者联合检测或可提高卵巢癌检出率。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.