Multiple Myeloma and Atopic Eczema in an Adult

Multiple myeloma is the fourteenth cause of cancer-related death. The symptoms of myeloma are mostly nonspecific, and there is significant delay between the first symptoms and diagnosis of myeloma. Atopic eczema is a common chronic inflammatory skin disease associated with dysregulation of the immune system. It generally develops in early childhood but can also occur in adults. Eczema is associated with a variety of hematological and solid malignancies, and possibly multiple myeloma. We report a patient with eczema that developed 5 years before the diagnosis of multiple myeloma but was mistaken for psoriasis.Key Words: Multiple myeloma, Atopic eczema, Early symptoms, Diagnostic criteria     

Elevated Erythropoietin and Multicystic Neoplasm of the Pancreas

Cystic lesions of the pancreas are more frequently recognized due to the widespread use of improved imaging techniques. There are a variety of pancreatic cystic lesions with different clinical presentations and malignant potentials, and their management depends on the type of the cysts. Although the early recognition of a cystic neoplasm with malignant potential provides an opportunity of early surgical treatment, the precise diagnosis of the cystic neoplasm can be a challenge, largely due to the lack of reliable biomarkers of malignant transformation. We report a case of a large, multicystic neoplasm within the body and tail of the pancreas complicated by elevated erythropoietin, which is likely related to the malignant transformation of the pancreatic neoplasm.Key Words: Cystic neoplasm, Pancreas, Erythropoietin, Biomarker     

Proteomic analysis of exosomes from nasopharyngeal carcinoma cell identifies intercellular transfer of angiogenic proteins

Exosomes, a group of secreted extracellular nanovesicles containing genetic materials and signaling molecules, play a critical role in intercellular communication. During tumorigenesis, exosomes have been demonstrated to promote tumor angiogenesis and metastasis while their biological functions in nasopharyngeal carcinoma (NPC) are poorly understood. In this study, we focused on the role of NPC‐derived exosomes on angiogenesis. Exosomes derived from the NPC C666‐1 cells and immortalized nasopharyngeal epithelial cells (NP69 and NP460) were isolated using ultracentrifugation. The molecular profile and biophysical characteristics of exosomes were verified by Western blotting, sucrose density gradient and electron microscopy. We showed that the C666‐1 exosomes (10 and 20 μg/ml) could significantly increase the tubulogenesis, migration and invasion of human umbilical vein endothelial cells (HUVECs) in a dose‐dependent manner. Subsequently, an iTRAQ‐based quantitative proteomics was used to identify the differentially expressed proteins in C666‐1 exosomes. Among the 640 identified proteins, 51 and 89 proteins were considered as up‐ and down‐regulated (≥ 1.5‐fold variations) in C666‐1 exosomes compared to the normal counterparts, respectively. As expected, pro‐angiogenic proteins including intercellular adhesion molecule‐1 (ICAM‐1) and CD44 variant isoform 5 (CD44v5) are among the up‐regulated proteins, whereas angio‐suppressive protein, thrombospondin‐1 (TSP‐1) was down‐regulated in C666‐1 exosomes. Further confocal microscopic study and Western blotting clearly demonstrated that the alteration of ICAM‐1 and TSP‐1 expressions in recipient HUVECs are due to internalization of exosomes. Taken together, these data strongly indicated the critical roles of identified angiogenic proteins in the involvement of exosomes‐induced angiogenesis, which could potentially be developed as therapeutic targets in future.     

A dual‐specific anti‐IGF‐1/IGF‐2 human monoclonal antibody alone and in combination with temsirolimus for therapy of neuroblastoma

The insulin‐like growth factors (IGFs), IGF‐1 and IGF‐2, have been implicated in the growth, survival and metastasis of a broad range of malignancies including pediatric tumors. They bind to the IGF receptor type 1 (IGF‐1R) and the insulin receptor (IR) which are overexpressed in many types of solid malignancies. Activation of the IR by IGF‐2 results in increased survival of tumor cells. We have previously identified a novel human monoclonal antibody, m708.5, which binds with high (pM) affinity to both human IGF‐1 and IGF‐2, and potently inhibits phosphorylation of the IGF‐1R and the IR in tumor cells. m708.5 exhibited strong antitumor activity as a single agent against most cell lines derived from neuroblastoma, Ewing family of tumor, rhabdomyosarcoma and osteosarcoma. When tested in neuroblastoma cell lines, it showed strong synergy with temsirolimus and synergy with chemotherapeutic agents in vitro. In xenograft models, the combination of m708.5 and temsirolimus significantly inhibited neuroblastoma growth and prolonged mouse survival. Taken together, these results support the clinical development of m708.5 for pediatric solid tumors with potential for synergy with chemotherapy and mTOR inhibitors.     

国产5-氨基水杨酸肠溶片治疗溃疡性结肠炎多中心临床研究

目的　评价国产 5 氨基水杨酸 (5 ASA)肠溶片治疗溃疡性结肠炎 (UC)的疗效和安全性及该药的口服吸收情况。方法　采用多中心、随机、双盲、双模拟和对照方案 ,将 1 2 9例UC患者随机分为5 ASA肠溶片试验组 (6 5例 ,2 .4 g/d)和水杨酸偶氮磺胺吡啶 (SASP)对照组 (6 4例 ,4 .0g/d) ,疗程均为6周。治疗第 8天 ,随机抽取试验组 1 3例和对照组 1 2例UC患者血清 ,应用高效液相色谱分析法检测血清 5 ASA及其代谢产物Ac 5 ASA的稳态血药浓度。对两组患者治疗前后的临床症状、粪便检查和肠镜检查的情况进行比较 ,并记录治疗过程中的不良反应。结果　实际完成研究者 1 2 0例 (5 ASA组 6 1例 ,SASP组 5 9例 ) ,两组各有 4例失访 ,SASP组有 1例因严重胃肠道不良反应中途退出。 5 ASA肠溶片组和SASP组治疗UC的总有效率分别为 70 .0 5 %和 6 7.79% ,两组间差异无显著性 (P >0 .0 5 ) ,5 ASA肠溶片的完全缓解率明显高于SASP (2 9.5 1 %比 1 3.31 % ,P <0 .0 5 )。 5 ASA肠溶片组和SASP组的不良反应分别为 1 1 .4 8%和 2 3.33%。 5 ASA组和SASP组的血清 5 ASA浓度分别为 (0 .0 32± 0 .0 0 8) μg/ml和 (0 .0 4 1± 0 .0 0 5 ) μg/ml(P >0 .0 5 )。 结论　 5 ASA肠溶片治疗UC总有效率与SASP相仿 ,但对UC的完     

急性心肌梗死不同时期血浆一氧化氮及内皮素变化的临床研究

目的：探讨内皮细胞损伤在急性心肌梗死发病中的作用及与梗塞相关并发症的关系。方法：将71例急性心肌梗死病人分为2组：A组41例，为无梗塞后缺血事件发作及严重并发症；B组30例，为有梗塞后缺血事件发作及严重并发症，并设立对照组15例。梗塞后4-6、24、72h及1周采用放免法测定血浆内皮素（ET），铜离子活化镉还原法测定血清中硝酸盐（NO3^-），采用Swan-Ganz导管测定肺毛细血管楔嵌压（PCWP）。结果：A组血浆ET在发病4-6h迅速升高，24h达高峰，1周恢复正常。而血浆NO于发病24h开始升高，72h达高峰值，1周恢复正常。B组ET在各个时点上均高于A组，在1周后仍高于对照组，B组血浆NO在各个时点上均低于A组，1周后仍低于对照组。且ET与PCWP呈显著正相关关系（r=0.82），而NO与PCWP无显著相关性。结论：急性心肌梗死时动态观察血浆ET、NO的变化，有助于判定梗塞后缺血事件的发生及并发症的出现，且血浆ET的持续升高会加重心功能的损害。     

脊髓型颈椎病的MRI改变及其临床意义

目的：探讨脊髓型颈椎病的MRI改变及其临床意义。方法：观察脊髓型颈椎病46例的MRI改变。结果：在MRI上重要改变为：椎间隙变窄，椎间盘信号减弱，受累节段椎体后缘存在信号减弱的致压物，受压颈髓弯曲、变形、向后移位，出现异常信号，这些改变直接反映受累颈椎间盘退行性病变和骨赘形成、颈髓受压和受损程度。结论：MRI对脊髓型颈椎病的诊断、治疗方法选择和预后判断有重要价值。     

儿童视网膜脱离38眼的回顾性防治分析

【目的】 总结儿童视网膜脱离的发病原因和治疗方法，探讨此种疾病的预防措施。【方法】 回顾性分析38眼儿童视网膜脱离的原因、手术方法、手术疗效和预后。【结果】 外伤和近视是儿童视网膜脱离最常见的原因，手术治疗使视网膜复位的成功率为94．7％，术后视力较术前视力提高，但较难达到完全正常。【结论】 手术治疗对儿童视网膜脱离有较高的成功率，但病程的拖延常导致视力恢复的效果较差。应加强宣传教育，增强儿童自我保护意识，避免眼外伤并正确处理眼外伤；注意用眼卫生，预防近视。对于有眼外伤或近视的儿童应定期复查，双眼检测，及早手术可减少儿童视网膜脱离的发病率，并促进视功能的恢复。