Prognostic significance of pleural fluid data in patients with malignant effusion

BACKGROUND: To determine the effects of the biochemical and cytological properties of the pleural fluid (PF) on the survival of patients with malignant pleural effusion (MPE). METHODS: A retrospective study of 284 patients with MPE was performed, which measured overall survival, survival of patients with different types of primary tumors, and survival as a function of PF biochemical variables transformed into quartiles. RESULTS: Median overall survival of MPE patients was 5.4 months following diagnosis. Survival varied significantly depending on the type of the primary tumor: 17.4 months for mesothelioma, 13.2 months for breast cancer, 7 months for lymphoma and 2.6 months for lung cancer. A multivariate analysis of PF biochemical parameters showed that survival was lower as the concentration of lactate dehydrogenase (LDH) increased (11.3 months if LDH was between 140 U/L and 358 U/L vs 2.8 months if LDH was between 1027 U/L and 10,110 U/L) or the concentration of pleural proteins decreased (9.4 months if proteins were between 4.92 g/dL and 7.94 g/dL vs 2.2 months if proteins were between 0.97 g/dL and 3.85 g/dL). We also found that when mesotheliomas were excluded from the analysis, survival was lower in patients with a PF pH lower than 7.3 (2.4 months vs 6.8 months, p=0.03). CONCLUSIONS: Tumor type as well as some biochemical features of the pleural fluid, such as pH and concentrations of proteins and LDH, influence survival in patients with MPE.     

Defective neuromuscular junction organization and postnatal myogenesis in mice with severe spinal muscular atrophy

A detailed pathologic analysis was performed on Smn(-/-);SMN2 mice as a mouse model for human type I spinal muscular atrophy (SMA). We provide new data concerning changes in the spinal cord, neuromuscular junctions and muscle cells, and in the organs of the immune system. The expression of 10 synaptic proteins was analyzed in 3-dimensionally reconstructed neuromuscular junctions by confocal microscopy. In addition to defects in postsynaptic occupancy, there was a marked reduction in calcitonin gene-related peptide and Rab3A in the presynaptic motor terminals of some, but not all, of the skeletal muscles analyzed. Defects in the organization of presynaptic nerve terminals were also detected by electron microscopy. Moreover, degenerative changes in muscle cells, defective postnatal muscle growth, and prominent muscle satellite cell apoptosis were also observed. All of these changes occurred in the absence of massive loss of spinal cord motoneurons. On the other hand, astroglia, but not microglia, increased in the ventral horn of newborn SMA mice. In skeletal muscles, the density of interstitial macrophages was significantly reduced, and monocyte chemotactic protein-1 was downregulated. These findings raise questions regarding the primary contribution of a muscle cell defect to the SMA phenotype.     

长期口服小剂量阿司匹林不能预防健康女性患2型糖尿病

慢性无临床症状的炎症与2型糖尿病的发生有关,流行病学资料认为这种关联在妇女表现得更为强烈。虽然小型临床研究显示短期口服大剂量阿司匹林具有明显的降糖效果,但是并没有随机试验直接评估临床可接受的剂量的阿司匹林预防糖尿病的效果。在美国一项随机、双盲、安慰剂-对照的女性健康研究（Women＇s Health Study）中,38716名45岁以上的且无临床糖尿病的健康女性随机口服小剂量的阿司匹林（n=19326）或安慰剂（n=19390）,     

Adjuncts to case assessment of vaginal discharge syndrome in pregnant women

ObjectiveTo investigate the aetiology of abnormal vaginal discharge, using a non-culture based method, among pregnant women presenting at the University of Calabar Teaching Hospital, Calabar, Nigeria.MethodsTwo hundred consecutive antenatal patients, aged 18 to 38 years, with complaints of abnormal vaginal discharge between 1st April and 31st July 2004 were investigated clinically for the characteristics of the vaginal discharge. High vaginal swabs taken from the vaginal fornices were examined using a non-culture based method to determine the possible aetiology of the discharge. The possibility of integrating non-culture based laboratory methods in the syndromic case management of abnormal vaginal discharge in an antenatal clinic setting is discussed.ResultsThe commonest form of abnormal discharge was curdy white in 66% of cases. Ten (5%) women had malodourous vaginal discharged, 92% had vulval itching; and superficial dyspareunia was seen in 29% of cases. Microscopic studies of vaginal discharge revealed the following findings: lactobacilli (96%), polymorphs (96%), 'clue' cells (4%); positive Whiff test (5%), and pH > 4.5 (7%). The clinical and laboratory assessment of each patient lasted between 35 and 45 minutes. The procedures used were acceptable to 78% of women.ConclusionThe use of non-culture based laboratory methods in the initial assessment of abnormal vaginal discharge can be a useful adjunct in the syndromic case management of abnormal vaginal discharge in pregnant women.     

Progression of Alzheimer's disease and effect of scFv‐h3D6 immunotherapy in the 3xTg‐AD mouse model: An in vivo longitudinal study using Magnetic Resonance Imaging and Spectroscopy

Alzheimer's disease (AD) is an incurable disease that affects most of the 47 million people estimated as living with dementia worldwide. The main histopathological hallmarks of AD are extracellular β‐amyloid (Aβ) plaques and intracellular neurofibrillary tangles (NFTs) composed of hyperphosphorylated tau protein. In recent years, Aβ‐immunotherapy has been revealed as a potential tool in AD treatment. One strategy consists of using single‐chain variable fragments (scFvs), which avoids the fragment crystallizable (Fc) effects that are supposed to trigger a microglial response, leading to microhemorrhages and vasogenic edemas, as evidenced in clinical trials with bapineuzumab. The scFv‐h3D6 generated by our research group derives from this monoclonal antibody, which targets the N‐terminal of the Aβ peptide and recognizes monomers, oligomers and fibrils. In this study, 3xTg‐AD mice were intraperitoneally and monthly treated with 100 μg of scFv‐h3D6 (a dose of ~3.3 mg/kg) or PBS, from 5 to 12 months of age (?mo), the age at which the mice were sacrificed and samples collected for histological and biochemical analyses. During treatments, four monitoring sessions using magnetic resonance imaging and spectroscopy (MRI/MRS) were performed at 5, 7, 9, and 12 months of age. MRI/MRS techniques are widely used in both human and mouse research, allowing to draw an in vivo picture of concrete aspects of the pathology in a non‐invasive manner and allowing to monitor its development across time. Compared with the genetic background, 3xTg‐AD mice presented a smaller volume in almost all cerebral regions and ages examined, an increase in both the intra and extracellular Aβ_1–42 at 12‐mo, and an inflammation process at this age, in both the hippocampus (IL‐6 and mIns) and cortex (IL‐6). In addition, treatment with scFv‐h3D6 partially recovered the values in brain volume, and Aβ, IL‐6, and mIns concentrations, among others, encouraging further studies with this antibody fragment.     

高透氧性硬性角膜接触镜治疗屈光参差性弱视的疗效评估

目的评估高透氧性硬性角膜接触镜治疗屈光参差性弱视的疗效。方法将符合屈光参差性弱视诊断的53例患者分为两组,A组26例配戴高透氧性角膜接触镜,B组27例配戴框架眼镜并同时给予遮盖、精细目力等弱视治疗,对比两组患者随访1个月、6个月、1年、2年后的疗效。结果在随访1个月、6个月、1年、2年后,A组患者的弱视眼矫正视力均明显提高,有效率显著高于B组患者,两组疗效差异具有统计学意义（P〈0.05）,且A组患者均能满意接受配戴RGP;1月后100%均感配戴舒适,在随访中未发现角膜上皮脱落、巨乳头性结膜炎、感染、眼部痛、痒等症状及眼镜护理方面的问题。结论高透气性硬性角膜接触镜基于其优质的像质和较小的像差,能安全、有效地治疗屈光参差性弱视,与其他治疗方法相比具有其独特的优越性。