European genome-wide association study identifies SLC14A1 as a new urinary bladder cancer susceptibility gene

Three genome-wide association studies in Europe and the USA have reported eight urinary bladder cancer (UBC) susceptibility loci. Using extended case and control series and 1000 Genomes imputations of 5 340 737 single-nucleotide polymorphisms (SNPs), we searched for additional loci in the European GWAS. The discovery sample set consisted of 1631 cases and 3822 controls from the Netherlands and 603 cases and 37 781 controls from Iceland. For follow-up, we used 3790 cases and 7507 controls from 13 sample sets of European and Iranian ancestry. Based on the discovery analysis, we followed up signals in the urea transporter (UT) gene SLC14A. The strongest signal at this locus was represented by a SNP in intron 3, rs17674580, that reached genome-wide significance in the overall analysis of the discovery and follow-up groups: odds ratio = 1.17, P = 7.6 × 10(-11). SLC14A1 codes for UTs that define the Kidd blood group and are crucial for the maintenance of a constant urea concentration gradient in the renal medulla and, through this, the kidney's ability to concentrate urine. It is speculated that rs17674580, or other sequence variants in LD with it, indirectly modifies UBC risk by affecting urine production. If confirmed, this would support the 'urogenous contact hypothesis' that urine production and voiding frequency modify the risk of UBC.     

剖宫产术后晚期产后出血11例分析

1临床资料1991-01/2004-10我院发生剖宫产术后晚期产后出血7例,外院转入4例,患者年龄25~34(平均26.6)岁.初产妇8例,经产妇3例,均为子宫下段剖宫产.出血发生在产后8~35(18±6)d(产后2~3wk多见),表现为突然发生阴道出血,鲜红色,出血量500~2500(平均1000)mL.患者均有头晕、心慌,合并出血性休克者6例.B超检查10例提示子宫下段切口有暗区,1例提示有胎盘残留.本组11例均用宫缩剂和广谱抗生素治疗,出血多或伴有休克者予输血,最多者输血2500mL,1例在B超监测下行清宫术,刮出物经病理证实为胎盘胎膜残留,7例行子宫次全切除术,3例行全子宫切除术.行子…     

医用透明质酸钠在老年膝骨关节炎关节镜术后的应用价值

1临床资料患者52(男15,女37)例,年龄55～72(平均58)岁.临床表现为膝关节疼痛,不同程度的肿胀,日常活动受限,部分有膝关节弹响、绞锁症状.髌骨研磨试验阳性,关节活动度轻度受限.X线表现根据Kellgren和Lawrence的放射学诊断标准分级[1],Ⅰ级-Ⅱ级为主.     

Radioimmunotherapy of relapsed B-cell lymphoma with yttrium 90 anti- idiotype monoclonal antibodies

Tumor-specific anti-idiotype (anti-Id) monoclonal antibodies (MoAbs) to B-cell lymphomas have been administered to patients, resulting in significant clinical responses. However, clinical responses have been limited by the emergence of Id-negative lymphoma. To overcome the problem of tumor heterogeneity, we conducted a pilot evaluation of the safety and effectiveness of yttrium 90 (90Y)-labeled anti-Id and shared Id (sId) MoAbs in non-Hodgkin's B-cell lymphoma. Nine patients with relapsed B-cell lymphoma in whom tumor was successfully targeted with 111In-labeled anti-Id MoAb were treated with 90Y-labeled anti-Id MoAb. A total of 19 courses (one to four per patient) were administered using 1,000 to 2,320 mg unlabeled clearing MoAb and 10 to 54 mCi 90Y MoAb per patient. Two of nine patients had a complete response, one a partial response, three stable disease, and three disease progression. Time to progression varied from 1 to 12 months. Toxicities were predominately hematologic, and only one patient developed infection and required transfusion. At progression, three of five assessable patients had Id- positive lymphoma and two had Id-negative lymphoma. Human antimouse antibodies (HAMA) did not develop in the patients after treatment. 90Y anti-Id MoAbs demonstrated excellent in vivo stability, produced significantly tumor regression in three of nine patients, exhibited acceptable toxicities, and elicited no HAMA formation. Further investigation of repetitive, low-dose 90Y anti-Id and MoAb therapy is warranted; however, the advantages of a pan B MoAb may prove the latter to be the agent of choice for the radio immunotherapy of B-cell lymphoma.     

Recurrent urinary tract infection and risk of bladder cancer in the Nijmegen bladder cancer study

Background:

Controversy exists on whether urinary tract infection (UTI) is a risk factor for urinary bladder cancer (UBC). Here, the association is investigated using data from one of the largest bladder cancer case–control studies worldwide.

Methods:

Information on (i) history and age at onset of regular cystitis (‘regular low-UTI'') and (ii) number and age at onset of UTI treated with antibiotics (‘UTI-ab'') from 1809 UBC patients and 4370 controls was analysed. Odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, education, smoking, and use of aspirin/ibuprofen were generated, for men and women separately.

Results:

Regular low-UTI was associated with an increased UBC risk (men: OR (95% CI) 6.6 (4.2–11); women: 2.7 (2.0–3.5)), with stronger effects in muscle-invasive UBC. Statistically significant decreased risks (ORs ∼0.65) were observed for up to five UTI-ab, specifically in those who (had) smoked and experienced UTI-ab at a younger age. In women, UTI experienced after menopause was associated with a higher UBC risk, irrespective of the number of episodes.

Conclusions:

Regular cystitis is positively associated with UBC risk. In contrast, a limited number of episodes of UTI treated with antibiotics is associated with decreased UBC risk, but not in never-smokers and postmenopausal women.     

Impairments,disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery

Purpose:?The aim of this study was to assess impairments, disabilities and health related Quality of Life (QOL) after treatment of breast cancer and to analyse the relationship between treatment modalities, impairments, disabilities and health related QOL.

Method:?Fifty-five patients who underwent a modified radical mastectomy or a segmental mastectomy with axillary lymph node dissection were retrospectively assessed with a mean follow up of 2.7 years after treatment. Impairments were assessed by means of measuring active shoulder range of motion, grip strength, arm volume and pain. Disabilities were assessed by means of the Shoulder Disability Questionnaire (SDQ) and health related QOL was assessed by means of the RAND 36-item Health Survey (RAND-36).

Setting:?University Hospital Groningen (The Netherlands).

Results:?Pain (60%) and reduction of grip-strength (40%) were the most frequent impairments found. The prevalence of impaired range of motion and oedema was 9?–?16% respectively 15%. Mean group score of the SDQ was 33.7 (sd: 32.1) and mean scores of the RAND-36 differed significantly for physical functioning, vitality and health perception to that of a female norm group. Radiotherapy and chemotherapy were significant factors in the prediction of impaired range of motion. Pain and restricted range of motion explained 61% respectively 12% of the variance in disability (SDQ). In the prediction of health related QOL, pain, grip strength and arm volume were significant factors respectively in six, three and two domains.

Conclusions:?Pain is the most frequent assessed impairment after breast cancer treatment with strong relationship to perceived disability and health related QOL. Disability is mild and health related QOL (RAND-36) differed in three of the nine domains with a female norm group.     

单螺旋和3股螺旋蚕丝纤维支架的力学性能及其细胞黏附性能比较

目的:经蚕茧缫丝脱胶而成的丝状纤维是一种无生理活性的天然结构性蛋白,这种结构使丝状支架具有良好的力学性质和生物相容性。观察采用单螺旋和3股螺旋蚕丝两种不同编织方法制备的丝状支架力学性能和细胞黏附性能的差异。方法:实验于2005-10/2006-05在华中科技大学同济医学院附属协和医院骨科实验室完成。将蚕丝用不同的编织方法制备单螺旋、3股螺旋两种丝状支架,直径4.5mm。实验方法:①丝状支架的力学检测:两种丝状支架各取10cm置于AGS-H多功能材料力学实验机的夹具中,固定后以10mm/min的速度行拉断试验。②对SD大鼠骨髓基质干细胞分离培养。实验评估:①通过拉断实验测定最大载荷、最大拉伸长度及弹性模量。②对骨髓基质干细胞进行苏木精-伊红染色。③扫描电镜观测骨髓基质干细胞与丝状支架的黏附情况。结果:①力学性能检测结果:单螺旋、3股螺旋两种丝状支架的最大载荷、最大拉伸长度、弹性模量[分别为(870±32),(846±20)N;(14.60±0.85),(13.90±0.64)mm;(6519±287),(6373±375)MPa]差异无显著性意义(P>0.05)。②免疫组织化学鉴定结果:骨髓间充质干细胞的细胞膜抗原CD44有阳性表达,CD34均为阴性表达。③骨髓基质干细胞与丝状支架的黏附情况:两种编织方法的丝状支架的丝状纤维表面均光滑,有较多的骨髓间充质干细胞黏附在丝状纤维上。结论:单螺旋和3股螺旋两种丝状支架的力学性能和细胞黏附性能相近。