CD15s抗原在肾移植急性排斥反应中的检测及其临床意义

目的探讨CD15s抗原在肾移植急性排斥反应中的检测和临床意义。方法将研究对象分为移植肾功能正常组、急性排斥反应组、其他原因引起移植肾功能不全组、健康对照组,采用流式细胞仪检测外周血淋巴细胞CD15s抗原表达率。各组分别于设定日期后第1、3、7、14、28天各采集标本1次。结果 CD15s抗原在移植肾功能正常组呈先降后升变化,但与其他原因引起肾功能不全组无显著差异;CD15s抗原表达率在急性排斥反应时明显增加(P<0.01),抗排斥治疗后逐渐下降。结论 CD15s抗原作为一项肾移植术后急性排斥反应的检测指标,能够准确反映患者的免疫功能状态。     

Cytological study of exfoliative buccal mucosal cells of Qat chewers in Yemen

Prevalence of oral cancer is relatively increasing in Yemen in recent years, which is ascribed to Qat with other carcinogens. Since the establishment of a simple and reliable method for the detection of oral cancerous and precancerous lesions is essential, exfoliative cytology (EC) was applied to a case-control study to appraise the presence and severity of oral epithelial atypia in 300 subjects (150 were Qat chewers and 150 were non-Qat users) without prior knowledge of the subjects' Qat exposure. Ten patients with oral squamous-cell carcinoma (OSCC) were included as internal controls. Cytological atypia and hyperkeratosis were demonstrated in six and 24 subjects, respectively, and could not be ascertained in the remaining 294 and 276 correspondingly. All of the 30 (six atypia and 24 hyperkeratosis) were among the 150 Qat chewers. Cytological atypia was found in all the 10 control cases with OSCCs (eight with severe degree and two with mild atypia). For the Qat among those with atypia and hyperkeratosis, the adjusted OR and the 95% confidence level were found to be 1.6 (0.8-7.2) and 3 (10.1-21.9), respectively. In view of these findings, we suggest the use of EC for detection and assessment of oral cytological atypia. Qat use contributes to the occurrence of cytological atypia that might develop to oral precancerous or cancerous lesions.     

Genotyping Sleep Disorders Patients

Objective

The genetic susceptibility factors underlying sleep disorders might help us predict prognoses and responses to treatment. Several candidate polymorphisms for sleep disorders have been proposed, but there has as yet inadequate replication or validation that the candidates may be useful in the clinical setting.

Methods

To assess the validity of several candidate associations, we obtained saliva deoxyribonucleic acid (DNA) samples and clinical information from 360 consenting research participants who were undergoing clinical polysomnograms. Ten single nucleotide polymorphisms (SNPs) were genotyped. These were thought to be related to depression, circadian sleep disorders, sleep apnea, restless legs syndrome (RLS), excessive sleepiness, or to slow waves in sleep.

Results

With multivariate generalized linear models, the association of TEF rs738499 with depressive symptoms was confirmed. Equivocal statistical evidence of association of rs1801260 (the C3111T SNP in the CLOCK gene) with morningness/eveningness and an association of Apolipoprotein E (APOE) rs429358 with the Epworth Sleepiness Scale (ESS) were obtained, but these associations were not strong enough to be of clinical value by themselves. Predicted association of SNPs with sleep apnea, RLS, and slow wave sleep were not confirmed.

Conclusion

The SNPs tested would not, by themselves, be of use for clinical genotyping in a sleep clinic.     

Apoptosis-inducing effect of erlotinib is potentiated by 3,3'-diindolylmethane in vitro and in vivo using an orthotopic model of pancreatic cancer

Blockade of epidermal growth factor receptor (EGFR) by EGFR tyrosine kinase inhibitors is insufficient for effective antitumor activity because of independently activated survival pathways. A multitargeted approach may therefore improve the outcome of anti-EGFR therapies. In the present study, we determined the effects of 3,3'-diindolylmethane (Bioresponse BR-DIM referred to as B-DIM), a formulated DIM with greater bioavailability on cell viability and apoptosis with erlotinib in vitro and in vivo using an orthotopic animal tumor model. BxPC-3 and MIAPaCa cells with varying levels of EGFR and nuclear factor-kappaB (NF-kappaB) DNA-binding activity were treated with B-DIM (20 micromol/L), erlotinib (2 micromol/L), and the combination. Cell survival and apoptosis was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and histone-DNA ELISA. Electrophoretic mobility shift assay was used to evaluate NF-kappaB DNA-binding activity. We found significant reduction in cell viability by both 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and clonogenic assays, induction of apoptosis, down-regulation of EGFR phosphorylation, NF-kappaB DNA-binding activity, and expression of antiapoptotic genes in BxPC-3 cells when treated with the combination of erlotinib and B-DIM compared with either agent alone. In contrast, no such effect was observed in MIAPaCa cells by similar treatment. Most importantly, these in vitro results were recapitulated in animal model showing that B-DIM in combination with erlotinib was much more effective as an antitumor agent compared with either agent alone. These results suggest that the utilization of B-DIM could be a useful strategy for achieving better treatment outcome in patients with activated status of EGFR and NF-kappaB in their tumors.     

Therapist emotional reactions and client resistance in cognitive behavioral therapy

Although extensively discussed in theoretical papers, empirical studies of therapist emotional reactions to clients are lacking, particularly within the context of client resistance and cognitive-behavioral therapy (CBT). The present study examined the early positive and negative emotional reactions to clients of four therapists, together with observed client in-session resistance, and changes in resistance from early to midtreatment, in a sample of 30 outpatients receiving eight sessions (14 hr) of CBT for generalized anxiety disorder. Findings indicated that greater therapist early positive reactions to clients, especially liking, enjoyment, and attachment, were associated with significantly lower levels of client resistance midtreatment and greater reductions in client resistance from early to midtreatment. These effects were independent of therapist competence in delivering CBT, suggesting a potentially unique and important role for therapist feelings about clients beyond the skillful delivery of treatment techniques. Greater early negative therapist reactions to clients were less consistently related to client resistance but power struggles, and feeling drained, helpless, guilty, and frustrated were associated with higher levels of client subsequent resistance.     

Apoptosis-inducing effect of chemotherapeutic agents is potentiated by soy isoflavone genistein, a natural inhibitor of NF-kappaB in BxPC-3 pancreatic cancer cell line

Cancer chemotherapeutic strategies should be devised to provide higher tumor response and lower toxicity for combination chemotherapy. Genistein has been shown to inhibit the growth of various cancer cells in vitro and in vivo without toxicity to normal cells. The antitumor effects of genistein could be in part due to inactivation of NF-kappaB activity. In contrast, chemotherapeutic agents inadvertently induce NF-kappaB activity, which may lead to chemoresistance. In this study, we investigated whether the inactivation of NF-kappaB by genistein would enhance the efficacy of chemotherapeutic agents. BxPC-3 pancreatic cancer cells were pretreated with 30 micromol/L genistein for 24 hours and then exposed to lower concentrations of chemotherapeutic agents for an additional 24 hours. Cell growth inhibition assay, apoptosis assay, and NF-kappaB EMSA were performed. The combination of 30 micromol/L genistein with 1 nmol/L docetaxel or 100 nmol/L cisplatin elicited significantly greater inhibition of cell growth compared with either agent alone. The combination treatment induced more apoptosis in BxPC-3 cells compared with single agents. Moreover, the NF-kappaB activity was significantly increased within 2 hours of docetaxel or cisplatin treatment, and the NF-kappaB-inducing activity of these agents was completely abrogated in cells pretreated with genistein. These results clearly suggest that genistein pretreatment, which inactivates NF-kappaB activity, together with other cellular effects of genistein, may contribute to increased cell growth inhibition and apoptosis inducing effects of nontoxic doses of docetaxel and cisplatin, which could be a novel strategy for the treatment of pancreatic cancer.     

商环包皮环切术与传统包皮环切术的临床疗效比较

目的对比分析商环包皮环切术与传统包皮环切术治疗包皮过长及包茎的临床疗效。方法对166例包皮过长及包茎患者随机分组,分别行传统包皮环切术86例（传统组）和商环包皮环切术80例（商环组）,对比分析两组的手术时间、术中出血量、术后疼痛程度及术后并发症等情况。结果商环组手术时间（4．78±1．11）min,术中出血量（1．06±0．23）ml,术后疼痛VAS评分（1．09±0．72）分,均显著低于传统组（P〈0．05）;且商环组在术后出血、感染、包皮畸形发生率等方面也低于传统组（P〈0．05）,但术后阴茎水肿发生率高于传统组（P〈0．05）。结论商环包皮环切术操作简单、微创、安全,患者痛苦小,较传统包皮环切术临床疗效好。     

Circadian Polymorphisms in Night Owls,in Bipolars,and in Non-24-Hour Sleep Cycles

People called night owls habitually have late bedtimes and late times of arising, sometimes suffering a heritable circadian disturbance called delayed sleep phase syndrome (DSPS). Those with DSPS, those with more severe progressively-late non-24-hour sleep-wake cycles, and those with bipolar disorder may share genetic tendencies for slowed or delayed circadian cycles. We searched for polymorphisms associated with DSPS in a case-control study of DSPS research participants and a separate study of Sleep Center patients undergoing polysomnography. In 45 participants, we resequenced portions of 15 circadian genes to identify unknown polymorphisms that might be associated with DSPS, non-24-hour rhythms, or bipolar comorbidities. We then genotyped single nucleotide polymorphisms (SNPs) in both larger samples, using Illumina Golden Gate assays. Associations of SNPs with the DSPS phenotype and with the morningness-eveningness parametric phenotype were computed for both samples, then combined for meta-analyses. Delayed sleep and "eveningness" were inversely associated with loci in circadian genes NFIL3 (rs2482705) and RORC (rs3828057). A group of haplotypes overlapping BHLHE40 was associated with non-24-hour sleep-wake cycles, and less robustly, with delayed sleep and bipolar disorder (e.g., rs34883305, rs34870629, rs74439275, and rs3750275 were associated with n=37, p=4.58E-09, Bonferroni p=2.95E-06). Bright light and melatonin can palliate circadian disorders, and genetics may clarify the underlying circadian photoperiodic mechanisms. After further replication and identification of the causal polymorphisms, these findings may point to future treatments for DSPS, non-24-hour rhythms, and possibly bipolar disorder or depression.     

Giant Retroperitoneal Lymphangioma: a Rare Entity

Retroperitoneal lymphangiomas are rare benign tumors, and the exact incidence of which is not well known. They usually arise from the developmental abnormalities of retroperitoneal lymphatics or their traumatic rupture. Confusion with other cystic tumors of the retroperitoneum including those arising from the kidney and pancreas is common. They usually lack specific symptoms and are mostly detected accidentally, while very rarely, some may present with complications such as rupture, torsion, hemorrhage, or infection. We report a case of a 22-year-old female in whom preoperative diagnosis of retroperitoneal lymphangioma was made on the basis of radiological investigations. On exploration, a large lymphangioma arising retroperitoneally was identified and excised. Postoperative recovery was uneventful.