Validation of the Chinese SF-36 for quality of life assessment in patients with systemic lupus erythematosus

We studied the reliability and validity of the Chinese Short-Form 36 Health Survey (SF-36) in a cross sectional study of patients with systemic lupus erythematosus (SLE). Sixty-nine consecutive subjects completed a questionnaire containing the Chinese SF-36 twice within 14 d. Disease activity and damage were assessed using the British Isles Lupus Activity Group (BILAG) and SLICC/ACR Damage Index (DI) scales, respectively. Internal consistency was assessed using Cronbach's alpha, reliability using Spearman's correlation and repeatability coefficients, and relationships between SF-36, BILAG and DI scores using Spearman's correlation. The Chinese SF-36 showed high internal consistency (alpha = 0.72-0.91) and good reliability, with correlations exceeding 0.70 for 7 scales and mean scale score differences of < 2 points for 6 scales. SF-36 scores correlated weakly with BILAG scores (-0.27 to -0.41) and DI scores (-0.24 to -0.35), and subjects' mean SF-36 scores were 6-24 points lower than the general population, supporting construct validity of the SP-36. These data suggest that the Chinese SF-36 is a reliable and valid measure of quality of life in patients with SLE.     

Hepatitis B virus infection in HIV-infected persons

Coinfection with HIV and hepatitis B virus (HBV) is common due to shared modes of transmission. The extended life expectancy of HIV-infected persons from effective antiretroviral therapy has led to the emergence of chronic hepatitis B (CHB) as an important problem. HIV adversely affects CHB, leading to accelerated progression of liver disease, as evidenced by an increased incidence of cirrhosis and liver-related mortality in coinfected persons. Furthermore, CHB increases the risk of hepatotoxicity from antiretroviral therapy, potentially jeopardizing the efficacy of HIV treatment. For these reasons, HIV-infected persons must be evaluated for coinfection with HBV and, if present, must be considered for CHB treatment. Management of CHB in HIV-infected persons is particularly complex due to lack of controlled trials, inability for current therapeutics to eradicate HBV, overlap in therapeutic agents for both viruses, and potential for development of drug-resistant HBV and HIV. Thus, treatment of HIV-HBV-coinfected patients requires simultaneous consideration of both viral infections. Further research is needed to determine the optimum management of CHB in HIV-infected persons.     

凝血酶敏感蛋白1对人肝癌细胞株HCCLM3生长和黏附的作用

目的:观察凝血酶敏感蛋白1对人肝癌细胞株HCCLM3的生长抑制和黏附的作用。方法:实验于2006-05/2007-01在河南省高等学校省级开放实验室完成。①采用浓度为2×107L-1的HCCLM3对数生长期单细胞悬液接种培养后,采用MTT法检测凝血酶敏感蛋白1对HCCLM3的生长抑制作用。②对数生长期的HCCLM3细胞株接种于纤黏连蛋白覆盖的96孔板后,按照处理因素分组:空白对照组、凝血酶敏感蛋白1组(加入凝血酶敏感蛋白1蛋白40mg/L)、CD36阻断组和CD47阻断组[先加入对应的单抗(浓度5mg/L),在体积分数为0.05CO2,37℃温箱孵育30min使单抗与细胞充分结合后再加入凝血酶敏感蛋白1]。培养72h后MTT方法检测凝血酶敏感蛋白1对细胞黏附力的作用,染色后直接计数黏附细胞。结果:①凝血酶敏感蛋白1对HCCLM3细胞的生长抑制率随着浓度的提高而增加,40mg/L与50mg/L相比抑制作用差异无显著性。抑制率随着时间的延长而增加,在72h抑制作用最明显。②黏附力的检测显示:凝血酶敏感蛋白1组,CD36阻断组,CD47阻断组细胞黏附力均显著低于对照组(P<0.05),但凝血酶敏感蛋白1组,CD36阻断组,CD47阻断组细胞黏附力差异无显著性(P>0.05)。结论:凝血酶敏感蛋白1对HCCLM3的生长有抑制作用,在一定范围内呈剂量依赖性和时间依赖性。凝血酶敏感蛋白1可抑制人肝癌细胞株HCCLM3与细胞外基质的黏附能力,作用途径可能与受体CD36,CD47无关。     

脐血CD34^＋细胞向肝细胞分化的体内外实验

目的:以脐血CD34 细胞为起始细胞,分别在人体外和肝受损的重度联合免疫缺陷小鼠体内诱导CD34 细胞向肝细胞转化。方法:实验于2004-09/2005-06在反应器工程国家重点实验室进行。取健康足月产妇的新鲜脐血,产妇知情同意。采用密度梯度离心法分离脐血单个核细胞。将单个核细胞悬浮于免疫磁珠法缓冲液中,获取CD34 细胞。将CD34 细胞在干细胞因子 白细胞介素3 白细胞介素6细胞因子组合中培养1周,然后在肿瘤抑制素 成纤维细胞因子1 成纤维细胞因子2 白血病抑制因子 肝细胞生长因子 表皮生长因子组合中诱导其向肝细胞分化。将2-乙酰氟氨以0.4mg/只的剂量通过腹腔注射输入到重度联合免疫缺陷小鼠体内。7d后再腹腔注射入0.4mL/kg的CCl4,同时向实验组小鼠尾部静脉注射CD34 细胞,对照组小鼠则仅输注2-乙酰氨芴和CCl4。分别于4,6周后采用流式细胞术检测小鼠肝脏中的人源细胞,并用RT-PCR和免疫组化方法检测人源血清白蛋白基因和抗原的表达。结果:①CD34 细胞体外培养过程中,细胞总数扩增了近30倍,并且在培养21d收获的细胞中可检测到人血清白蛋白基因和抗原的表达,CD34 在体外被诱导成肝样细胞。②采用流式细胞术检测重度联合免疫缺陷小鼠肝脏中的人源细胞,并用RT-PCR和免疫组化的方法检测人源血清白蛋白基因和抗原的表达,4周时发现小鼠肝脏中含有7.66%的人源细胞,但人源细胞不表达血清白蛋白基因和抗原。6周时重度联合免疫缺陷小鼠肝脏中的人源细胞的比例增加至31.10%,并且人源细胞开始表达血清白蛋白基因和抗原。结论:CD34 细胞无论在体外培养还是在肝脏受损的重度联合免疫缺陷小鼠体内均能成功转化为肝实质细胞。     

Knowledge regarding hepatitis B mother‐to‐child transmission among healthcare workers in South China

To determine the knowledge regarding hepatitis B virus (HBV) mother‐to‐child transmission (MTCT) and its prevention and treatment among healthcare workers (HCWs) in Guangdong Province, China, an HBV endemic area. An HBV knowledge questionnaire was administered to 900 HCWs from the 3rd Affiliated Hospital of Sun Yat‐Sen University and 2 rural hospitals in Guangdong Province. The 27 items in the questionnaire fell into 3 sections: HBV MTCT general knowledge, respondents’ practices of preventing HBV MTCT and awareness of the resources of preventing HBV MTCT. The data collected were coded and analysed using SPSS software version 20. In total, 503 of 900 HCWs responded to the survey (response rate: 55.9%). Eighty‐four individuals responded correctly to all of the knowledge questions: 58 were doctors, and 26 were nurses (P < .05). Doctors more often performed practices than nurses (t = 3.591, P < .01). Participants from the infectious disease department demonstrated a significantly higher proportion of correct answers and resource utilization than other specialties (χ² = 14.052, 7.998, P < .01). In terms of the average knowledge score, t test or ANOVA showed that there were significant differences between the specialty groups (t = 3.110, P < .01), hospital level groups (t = 2.337, P < .05) and age groups (F = 3.020, P < .05). Respondents’ initiative increased with hospital level and age (t = 2.993, 7.493, P < .01). A considerable percentage of HCWs has misconceptions about HBV MTCT. Healthcare workers, in particular nurses, those working in noninfectious disease departments or township hospitals and younger medical staff, lack systematic and comprehensive knowledge about HBV MTCT and are in urgent need of HBV‐related training.     

A comparison of DNA sequencing and gene expression profiling to assist tissue of origin diagnosis in cancer of unknown primary

Cancer of unknown primary (CUP) is a syndrome defined by clinical absence of a primary cancer after standardised investigations. Gene expression profiling (GEP) and DNA sequencing have been used to predict primary tissue of origin (TOO) in CUP and find molecularly guided treatments; however, a detailed comparison of the diagnostic yield from these two tests has not been described. Here, we compared the diagnostic utility of RNA and DNA tests in 215 CUP patients (82% received both tests) in a prospective Australian study. Based on retrospective assessment of clinicopathological data, 77% (166/215) of CUPs had insufficient evidence to support TOO diagnosis (clinicopathology unresolved). The remainder had either a latent primary diagnosis (10%) or clinicopathological evidence to support a likely TOO diagnosis (13%) (clinicopathology resolved). We applied a microarray (CUPGuide) or custom NanoString 18-class GEP test to 191 CUPs with an accuracy of 91.5% in known metastatic cancers for high–medium confidence predictions. Classification performance was similar in clinicopathology-resolved CUPs – 80% had high–medium predictions and 94% were concordant with pathology. Notably, only 56% of the clinicopathology-unresolved CUPs had high–medium confidence GEP predictions. Diagnostic DNA features were interrogated in 201 CUP tumours guided by the cancer type specificity of mutations observed across 22 cancer types from the AACR Project GENIE database (77,058 tumours) as well as mutational signatures (e.g. smoking). Among the clinicopathology-unresolved CUPs, mutations and mutational signatures provided additional diagnostic evidence in 31% of cases. GEP classification was useful in only 13% of cases and oncoviral detection in 4%. Among CUPs where genomics informed TOO, lung and biliary cancers were the most frequently identified types, while kidney tumours were another identifiable subset. In conclusion, DNA and RNA profiling supported an unconfirmed TOO diagnosis in one-third of CUPs otherwise unresolved by clinicopathology assessment alone. DNA mutation profiling was the more diagnostically informative assay. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.