Incidence of Pleural Effusion in Patients with Pulmonary Embolism

Background:

No data on the incidence of pleural effusion (PE) in Chinese patients with pulmonary embolism are available to date. The aim of the current study was to investigate the frequency of PE in a Chinese population of patients with pulmonary embolism.

Methods:

This was a retrospective observational single-center study. All data of computed tomography pulmonary angiography (CTPA) performed over 6-year period on adult patients with clinically suspected pulmonary embolism were analyzed.

Results:

From January 2008 until December 2013, PE was identified in 423 of 3141 patients (13.5%) with clinically suspected pulmonary embolism who underwent CTPA. The incidence of PE in patients with pulmonary embolism (19.9%) was significantly higher than in those without embolism (9.4%) (P < 0.001). Majority of PEs in pulmonary embolism patients were small to moderate and were unilateral. The locations of emboli and the numbers of arteries involved, CT pulmonary obstruction index, and parenchymal abnormalities at CT were not associated with the development of PE.

Conclusions:

PEs are present in about one fifth of a Chinese population of patients with pulmonary embolism, which are usually small, unilateral, and unsuitable for diagnostic thoracentesis.     

综合性护理干预对社区老年痴呆患者的影响

目的探讨综合性护理干预措施对社区老年痴呆患者的影响。方法将68例老年痴呆患者随机分为对照组和试验组,每组各34例。对照组运用常规方法进行护理,试验组给予综合性护理干预措施。结果两组患者在干预后的ADL和MMSE评分均显著高于护理前(P<0.05),且干预后试验组患者在ADL和MMSE评分显著高于对照组,差异有统计学意义(P<0.05)。结论老年性痴呆病因尚不清楚,综合性护理干预对老年痴呆效果显著,对阻止疾病的发展有重要意义。     

可诱导表达BMP4的正常来源及隐睾特异性iPSCs的建立及分化研究

目的建立可诱导表达骨形态发生蛋白质4(bone morphogenetic protein 4,BMP4)的正常来源及隐睾特异性诱导多能干细胞(induced pluripotent stem cells,iPSCs),比较两者体外定向分化的差异,为研究部分隐睾患儿成年后不育的原因提供具有人类遗传背景的体外研究模型。方法①建立可诱导表达BMP4的正常来源及隐睾特异性iPSCs,将正常来源iPSCs作为对照组,隐睾特异性iPSCs作为隐睾组;利用多西环素(doxycycline,Dox)进行诱导,筛选出BMP4表达量最高的细胞株;②将外源性添加BMP4的正常来源iPSCs作为外源性添加BMP4组(外源组),将Dox内源诱导BMP4表达的正常来源iPSCs作为Dox内源诱导BMP4表达组(内源组),此两组共同作为实验组;在细胞形态和基因表达水平比较实验组两组间BMP4因子诱导效果的差异;③通过Dox诱导BMP4的表达、双氢睾酮(dihydrotestosterone,DHT)、全反式维甲酸(all trans retinoid acid,ATRA)组成的三步法诱导分化方案,逐步诱导人的正常来源及隐睾特异性iPSCs向生精细胞方向分化,在基因及蛋白水平进行检测,比较两株细胞在分化过程中的差异。结果①经Dox诱导后,在正常来源及隐睾特异性iPSCs两株细胞中均可检测到BMP4表达明显升高、同时多能性基因OCT4的表达均呈明显下降趋势,与d0相比差异具有统计学意义,其中对照组的3#细胞株与隐睾组的5#细胞株在Dox诱导后BMP4表达量最高;②与外源组相比,内源组的细胞株形态变化更为均一、同步,BMP4的基因表达量更高,两组间的差异具有统计学意义;③在向生精细胞诱导分化过程中,对照组及隐睾组细胞的DAZL和PRDM1的表达量在两组之间的差异均无统计学意义;隐睾组的VASA、SYCP3、ACROSIN和TEKT1的表达量于诱导d14和d21时均明显低于对照组,两组之间的差异具有统计学意义。免疫染色结果显示:DAZL的阳性率在对照组和隐睾组细胞间的差异无统计学意义;隐睾组的VASA和SYCP3的阳性率于诱导d14和d21时均明显低于对照组,ACROSIN的阳性率于诱导d21时明显低于对照组,差异均具有统计学意义。结论本研究为部分隐睾患儿成年后不育的原因提供了具有人类遗传背景的体外研究模型,为未来的进一步研究奠定了良好基础。     

Short telomere length in peripheral blood leukocyte predicts poor prognosis and indicates an immunosuppressive phenotype in gastric cancer patients

Compelling evidences indicate that relative telomere length (RTL) in peripheral blood leukocytes (PBLs) can predict the clinical outcome of several cancers. However, to date, the prognostic value of leukocyte RTL in gastric cancer (GC) patients has not been explored. In this study, relative telomere length (RTL) in peripheral blood leukocytes (PBLs) was measured using a real‐time PCR‐based method in a total of 693 GC patients receiving surgical resection. The prognostic value of leukocyte RTL was first explored in the training set (112 patients) using Kaplan–Meier and Cox proportional hazards regression analyses. Then an independent cohort of 581 patients was used as a validation set. To explore potential mechanism, we detected the immunophenotypes of peripheral blood mononuclear cells and plasma concentrations of several cytokines in GC patients. Patients with short RTL showed significantly worse overall survival (OS) and relapse‐free survival (RFS) than those with long RTL in all patient sets. Furthermore, leukocyte RTL and TNM stage exhibited a notable joint effect in prognosis prediction. Integration of TNM stage and leukocyte RTL significantly improved the prognosis prediction efficacy for GC. In addition, we found that patients with short RTL had a higher CD4+ T cell percentage in PBMCs, CD19+IL‐10+ Breg percentage in B cells and plasma IL‐10 concentration, indicating an enhanced immunosuppressive status with short leukocyte RTL. In conclusion, our study for the first time demonstrates that leukocyte RTL is an independent prognostic marker complementing TNM stage and associated with an immunosuppressive phenotype in the peripheral blood lymphocytes in GC patients.     

晚期前列腺癌间歇与持续性内分泌治疗的临床观察

目的:观察比较晚期前列腺癌间歇性内分泌治疗(IHT)与持续性内分泌治疗(CHT)的疗效和不良反应。方法:选取确诊的晚期前列腺癌患者共96例,之前未接受治疗,随机分为:间歇治疗组(A组)和持续治疗组(B组)。A组:54例,给予比卡鲁胺(50mg,口服,每日1次)和戈舍瑞林(3.6mg,皮下注射,每月1次)治疗,当患者血清PSA≤0.2ng/ml,暂停服用药物比卡鲁胺,当患者血清PSA>4ng/ml时,重新开始服用药物比卡鲁胺。B组:42例,同时给予比卡鲁胺和戈舍瑞林治疗,不间断治疗。终止治疗的标准是病人由激素依赖转为激素抵抗性前列腺癌。比较两组治疗前、治疗后半年、1年、2年后血清PSA、疼痛缓解及排尿梗阻症状改善情况、生活质量评分、不良反应。结果:血清PSA、疼痛缓解以及排尿梗阻改善情况上,两组治疗后各时间段较治疗前均得到显著改善(P<0.05),但两组之间无显著差异(P>0.05)。A组治疗后不良反应中去势综合征、转氨酶升高、贫血以及乳房发育发生率较B组显著降低(P<0.05),生活质量评分明显升高(P<0.05)。结论:IHT和CHT对晚期前列腺癌治疗效果无明显差异,都能缓解患者的症状和提高患者的生活质量,但IHT不良反应发生率较持续治疗显著降低,生活质量明显提高,值得临床椎广。     

Inhibition of tumor growth by a newly-identified activator for epidermal fatty acid binding protein

Our previous studies have demonstrated that expression of epidermal fatty acid binding protein (E-FABP) in tumor associated macrophages (TAMs) promotes macrophage anti-tumor activity by enhancing IFNβ responses in tumor models. Thus, E-FABP represents a new protective factor in enhancing tumor immune surveillance against tumor development. Herein, we report the compound 5-(benzylamino)-2-(3-methylphenyl)-1,3-oxazole-4-carbonitrile (designated EI-05) as a novel E-FABP activator for inhibition of mammary tumor growth. EI-05 was selected from the ZINC compound library using molecular docking analysis based on the crystal structure of E-FABP. Although EI-05 is unable to bind E-FABP directly, it significantly increases E-FABP expression in macrophages during inflammation. Stimulation of macrophages with EI-05 remarkably enhances lipid droplet formation and IFNβ production, which further promotes the anti-tumor activity of macrophages. Importantly, administering EI-05 in vivo significantly inhibits mammary tumor growth in a syngeneic mouse model. Altogether, these results suggest that EI-05 may represent a promising drug candidate for anti-tumor treatment through enhancing E-FABP activity and IFNβ responses in macrophages.     

Retargeted human avidin-CAR T cells for adoptive immunotherapy of EGFRvIII expressing gliomas and their evaluation via optical imaging

There has been significant progress in the design of chimeric antigen receptors (CAR) for adoptive immunotherapy targeting tumor-associated antigens. However, the challenge of monitoring the therapy in real time has been continually ignored. To address this issue, we developed optical molecular imaging approaches to evaluate a recently reported novel CAR strategy for adoptive immunotherapy against glioma xenografts expressing EGFRvIII. We initially biotinylated a novel anti-EGFRvIII monoclonal antibody (biotin-4G1) to pre-target EGFRvIII⁺ gliomas and then redirect activated avidin-CAR expressing T cells against the pre-targeted biotin-4G1. By optical imaging study and bio-distribution analysis, we confirmed the specificity of pre-target and target and determined the optimal time for T cells adoptive transfer in vivo. The results showed this therapeutic strategy offered efficient therapy effect to EGFRvIII⁺ glioma-bearing mice and implied that optical imaging is a highly useful tool in aiding in the instruction of clinical CAR-T cells adoptive transfer in future.