CD44 的阳性表达与肝细胞癌患者生存预后结果的Meta 分析

目的 探索肿瘤标志物CD44 与肝细胞癌临床病理特点及肝细胞癌患者生存预后之间的联系。方法检索PubMed,EMbase 和Cochrane 图书馆数据库,截止日期为2017 年8 月2 日。采用STATA 软件对肿瘤细胞CD44 的阳性表达与肝癌的肿瘤临床分期,肿瘤分级,甲胎蛋白等临床病理特征,及CD44 阳性表达与肝癌患者生存预后结果包括总生存率（OS）和无病生存率（DFS）之间进行荟萃分析。结果 10 篇文章符合纳入标准,共对 1 620 例患者进行荟萃分析。CD44 的阳性表达与肝癌患者的临床分期（O^^R=1.41,95%CI ：1.02,1.93）,及肿瘤分级（O^^R=1.29,95%CI：1.02,1.62）,差异有统计学意义,然而CD44阳性表达与肝癌患者甲胎蛋白水平 高低、乙肝病毒感染、血管侵犯及肿瘤大小等差异无统计学意义;CD44 阳性表达与肝癌患者生存预后密切相关,包括总生存率（R^^R=1.44,95%CI：1.29,1.61）,无病生存率（R^^R=1.45,95%CI：1.30,1.61）,差异有统计学意义。结论 CD44 阳性表达与肝癌患者预后不良密切相关。     

泌尿外科导尿管与非导尿管相关性尿路感染病原菌分布及耐药性比较

目的 探讨泌尿外科导尿管与非导尿管相关性尿路感染病原菌及耐药性,为临床合理使用抗菌药物提供依据。方法 选取2013 年１月-2015 年10 月该院泌尿外科收治的尿路感染患者,分为导尿管组与非导尿管组。采集合格尿标本进行细菌培养及药物敏感实验,进行统计学分析。结果 导尿管组与非导尿管组病原学分布差异有统计学意义（P <0.05）。导尿管组革兰阳性菌以葡萄球菌属细菌较多,金黄色葡匋球菌为主,而非导尿管组革兰阳性菌以肠球菌属细菌为主;导尿管组革兰阴性菌以非发酵菌较多,非导尿管组以肠杆菌科细菌为主。导尿管组检出肠杆菌科细菌耐药率较非导尿管组高;导尿管组检出鲍曼不动杆菌、金黄色葡萄球菌及肠球菌耐药率高于非导尿管组。结论 导尿管与非导尿管相关性尿路感染的病原菌分布存在差异,导尿管相关性尿路感染病原菌耐药率高于非留置导尿管患者。     

双重实时荧光逆转录聚合酶链反应检测尿液DD3/PSA mRNA比值及其应用

目的建立双重实时荧光逆转录聚合酶链反应（RT—PCR）检测尿液DD3／PSAmRNA比值,评价其初步应用。方法分别在前列腺特异性抗原（PSA）基因外显子1和2、差异显示编码3（DD3）基因外显子1和3之间设计一对引物和一条探针,PSA和DD3基因的TaqMan—MGB探针5’分别标记HEX和FAM荧光素,建立双重实时荧光RT—PCR检测尿液DD3／PSAmRNA比值的方法,并对方法学进行评价。对34例前列腺癌（PCa）、44例良性前列腺增生（BPH）患者前列腺按摩后尿液中的DD3／PSAmRNA比值进行检测,评价其临床应用价值。结果扩增产物经测序证明为PSA和DD3特异性片段。以LNCaP细胞cDNA作模板,PSAmRNA和DD3mRNA最低检测限分别为0,6细胞／反应和60细胞／反应。DD3／PSAmRNA比值批内、批间变异系数分别为3．8％-4,7％和4．1％-4,9％。PCa组尿液DD3／PSAmRNA比值明显高于BPH组（P〈0．01）。尿液DD3／PSAmRNA比值诊断PCa的ROC曲线下面积（AUC）为0．746（95％CI：0．630—0．862）,当截断值为0．254时其敏感度和特异度分别为64．7％和77.3％,其阳性率与临床和病理分级均无关。结论成功建立了双重实时荧光RT—PCR检测尿液DD3／PSAmRNA比值的分子生物学诊断方法。该方法对PCa诊断具有较高特异度和敏感度,且节省操作时间、降低实验成本,有望成为PCa早期诊断的有效方法。     

Effect of rimonabant on progression of atherosclerosis in patients with abdominal obesity and coronary artery disease: the STRADIVARIUS randomized controlled trial

Context  Abdominal obesity is associated with metabolic abnormalities and increased risk of atherosclerotic cardiovascular disease. However, no obesity management strategy has demonstrated the ability to slow progression of coronary disease. Objective  To determine whether weight loss and metabolic effects of the selective cannabinoid type 1 receptor antagonist rimonabant reduces progression of coronary disease in patients with abdominal obesity and the metabolic syndrome. Design, Setting, and Patients  Randomized, double-blinded, placebo-controlled, 2-group, parallel-group trial (enrollment December 2004-December 2005) comparing rimonabant with placebo in 839 patients at 112 centers in North America, Europe, and Australia. Interventions  Patients received dietary counseling, were randomized to receive rimonabant (20 mg daily) or matching placebo, and underwent coronary intravascular ultrasonography at baseline (n = 839) and study completion (n = 676). Main Outcome Measures  The primary efficacy parameter was change in percent atheroma volume (PAV); the secondary efficacy parameter was change in normalized total atheroma volume (TAV). Results  In the rimonabant vs placebo groups, PAV (95% confidence interval [CI]) increased 0.25% (–0.04% to 0.54%) vs 0.51% (0.22% to 0.80%) (P = .22), respectively, and TAV decreased 2.2 mm³ (–4.09 to –0.24) vs an increase of 0.88 mm³ (–1.03 to 2.79) (P = .03). In the rimonabant vs placebo groups, imputing results based on baseline characteristics for patients not completing the trial, PAV increased 0.25% (–0.04% to 0.55%) vs 0.57% (0.29% to 0.84%) (P = .13), and TAV decreased 1.95 mm³ (–3.8 to –0.10) vs an increase of 1.19 mm³ (–0.73 to 3.12) (P = .02). Rimonabant-treated patients had a larger reduction in body weight (4.3 kg [–5.1 to –3.5] vs 0.5 kg [–1.3 to 0.3]) and greater decrease in waist circumference (4.5 cm [–5.4 to –3.7] vs 1.0 cm [–1.9 to –0.2]) (P < .001 for both comparisons). In the rimonabant vs placebo groups, high-density lipoprotein cholesterol levels increased 5.8 mg/dL (4.9 to 6.8) (22.4%) vs 1.8 mg/dL (0.9 to 2.7) (6.9%) (P < .001), and median triglyceride levels decreased 24.8 mg/dL (–35.4 to –17.3) (20.5%) vs 8.9 mg/dL (–14.2 to –1.8) (6.2%) (P < .001). Rimonabant-treated patients had greater decreases in high-sensitivity C-reactive protein (1.3 mg/dL [–1.7 to –1.2] [50.3%] vs 0.9 mg/dL [–1.4 to –0.5] [30.9%]) and less increase in glycated hemoglobin levels (0.11% [0.02% to 0.20%] vs 0.40% [0.31% to 0.49%]) (P < .001 for both comparisons). Psychiatric adverse effects were more common in the rimonabant group (43.4% vs 28.4%, P < .001). Conclusions  After 18 months of treatment, the study failed to show an effect for rimonabant on disease progression for the primary end point (PAV) but showed a favorable effect on the secondary end point (TAV). Determining whether rimonabant is useful in management of coronary disease will require additional imaging and outcomes trials, which are currently under way. Trial Registration  clinicaltrials.gov Identifier: NCT00124332      

Establishment of a sandwich ELISA method for detection of vascular endothelial growth factor in serum samples of hepatocellular carcinoma patients

Objective To establish a sandwich ELISA method for detecting vascular endothelial growth factor （VEGF） in sera of population and the patients with hepatocellular carcinoma （HCC）. Methods Full length and two truncated human VEGF cDNA sequences were amplified from a commercial plasmid pBLAST49-hVEGF by PCR and inserted into the prokaryotic-expression plasmid pET-32a or pGEX-2T. Various VEGF proteins were expressed and purified from E. coli in His-Trx or GST fusion forms. The specific VEGF antibodies were elicited in experimental rabbits and mice by immunization of the full length VEGF fusion protein His-Trx-VEGF1-165. After purification of antibodies with chromatograph of Protein G, a sandwich ELISA technique was established. Serum VEGF levels were evaluated in 229 adults and 291 HCC patients. Results SDS-PAGE displayed that the molecular weights of the expressed full length （His-Trx-VEGF1-165）, N-terminal （His-Trx-VEGF1-100） and C-terminal （GST-VEGF100-165） human VEGF fusion proteins were about 38KD, 31KD, and 33KD, respectively. Western blots confirmed that the prepared antisera were able to recognize both prokaryoticly and eukaryoticly expressed recombinant VEGF proteins. Assays of serially diluted His-Trx-VEGF1-100 by the established sandwich ELISA method showed that the linear range of the standard curve was 0.625-320 ng/mL, with the squared correlation coefficient R^2=0.991. Screening of a serum panel containing 291 serum samples of HCC patients and 229 health adults revealed that the average VEGF level in HCC patients was higher than that in healthy controls, with a statically significant difference. Conclusion The established sandwich ELISA reflects the level of serum VEGF and provide scientific basis for screening metastasis and recurrence of HCC using serum VEGF as an index.     

犬急性膝关节炎炎症期滑膜组织μ-阿片受体的表达

目的:观察犬急性膝关节炎炎症期滑膜组织μ-阿片受体(mu-opioid receptors,MOR)表达的变化,探讨急性炎症外周局部应用阿片类药物镇痛的可行性.方法:17只Beagle犬随机分为正常对照组(n=8)和急性感染性炎症组(n=9),取各组犬膝关节滑膜组织,采用免疫组织化学及real-time PCR方法检测滑膜组织M0R蛋白及mRNA的表达.结果:急性感染性炎症组犬膝关节滑膜组织MOR mRNA相对表达量明显高于正常对照组[(34.40±5.48)% vs(16.54±8.03)%],差异具有统计学意义(P＜0.05).免疫组化染色见炎症滑膜组织M0R染色阳性产物较正常对照颗粒增粗、着色加深、染色带增宽、数量增多;与正常滑膜组织相比,急性感染性炎症组滑膜组织MOR阳性细胞免疫组化指数显著增高[(323 175.00±92 614.94)vs(175 444.10±75 149.06)],差异具有统计学意义(P＜0.05).结论:犬膝关节滑膜组织中存在MOR,且在急性感染性炎症早期其表达显著增强.     

Identification and Characterization of Peptide Mimics of Blood Group A Antigen

In order to investigate peptide mimics of carbohydrate blood group A antigen, a phage display 12-mer peptide library was screened with a monoclonal antibody against blood group A antigen, NaM87-1F6. The antibody-binding properties of the selected phage peptides were evaluated by phage ELISA and phage capture assay. The peptides were co-expressed as glutathione S-transferase （GST） fusion proteins. RBC agglutination inhibition assay was performed to assess the natural blood group A antigen-mimicking ability of the fusion proteins. The results showed that seven phage clones selected bound to NaM87-1F6 specifically, among which, 6 clones bore the same peptide sequence, EYWYCGMNRTGC and another harbored a different one QIWYERTLPFTF. The two peptides were successfully expressed at the N terminal of GST protein. Both of the fusion proteins inhibited the RBC agglutination mediated by anti-A serum in a concentration-dependent manner. These results suggested that the fusion proteins based on the selected peptides could mimic the blood group A antigen and might be used as anti-A antibody-adsorbing materials when immunoabsorption was applied in ABO incompatible transplantation.     

Aspergillus pneumonia in renal transplant recipients

Background Filamentous fungal infections are associated with a high morbidity and mortality in solid organ transplants The present study aimed to investigate the aspergillus pneumonia in renal transplant recipients, and its diagnosis as well as treatment. Methods Approximately 2000 cases of renal transplants were retrospectively studied and we focused on cases hospitalized during August 1, 2005 and February 1, 2007, as the study period. The clinical database and electronic records were analyzed. Recently published literature was reviewed. Results There was more diabetes and hypertension in the infected group than in the non-infected group （86% vs 62% and 57% vs 39%, respectively）. Eighty-six percent of recipients from the infected group had delayed graft function. Seven cases with aspergillus pneumonia were identified based on either fungal culture or radiology. Of the 7 cases, 4 died in a few days after diagnosis. Liposomal amphotericin B was used as a first-line therapy. Conclusions Incidences of fungal infection are increasing among renal transplant recipients. Early diagnosis and treatment are critical steps in curing aspergillosis.     

果糖治疗不稳定性心绞痛的临床疗效

目的　观察果糖治疗不稳定性心绞痛的疗效 .方法　 138例患者随机分为果糖组 (70例 )和对照组 (6 8例 ) ,观察心绞痛发作次数 ,12导联心电图变化和心脏事件发生次数(心肌梗死、猝死、严重的心律失常 ) .结果　心绞痛发作次数 :果糖组和对照组明显低于治疗前 (P<0 .0 1) ,治疗后果糖组也明显低于对照组 [(0 .6 8± 0 .5 7)次· d- 1 vs(1.0 4± 0 .81)次· d- 1 ,P<0 .0 1];12导联心电图改善的比较 :果糖组 (4 9/70例 )明显优于对照组 (36 / 6 8例 ,P<0 .0 5 ) ;心脏事件发生上 ,果糖组明显低于对照组 (8/ 70例比 17/ 6 8例 ,P <0 .0 5 ) .结论　果糖治疗不稳定性心绞痛有明显的临床疗效     

肺淋巴管肌瘤病的临床分析

目的探讨肺淋巴管肌瘤病 (LAM)的临床特征、疗效和预后,提高对该病的认识. 方法回顾性分析经治的2例LAM病人并复习文献14例LAM病人的临床资料. 结果经治的2例病人均以呼吸困难为主要症状,肺功能检查均为阻塞性通气功能障碍和弥散功能减低.16例LAM病人中女性15例(94%),男性1例(6%);发病年龄5～69(35±15)岁,13例(81%)为中青年生育期女性.均经肺组织活检病理确诊.主要临床表现为呼吸困难(15例)、咯血(10例)、气胸(7例)、乳糜胸(7例)等.14例行胸部高分辨CT(HRCT)扫描,均显示两肺弥漫性薄壁囊状阴影.7例行肺功能检查,均有弥散功能减低,5例有肺阻塞性通气功能障碍,2例有混合性通气功能障碍.11例作了动脉血气分析,其中8例表现为低氧血症,5例合并呼吸衰竭.16例病人首次就诊时均被误诊为其他疾病,自首发症状至确诊LAM经历2～276个月,中位数为28个月.6例病人应用安宫黄体酮治疗6～50个月,2例病情稳定,2例病情加重,2例死亡.16例中6例(38%)在症状出现后1.5～26年内因呼吸衰竭、气胸和肺部感染死亡. 结论 LAM以呼吸困难、咯血、气胸和乳糜胸为主要临床特征.安宫黄体酮疗效不理想.探讨病因及寻找有效的疗法是今后研究的重要课题.