Immunoglobulin D-λ/λ biclonal multiple myeloma: A case report

BACKGROUNDImmunoglobulin D (IgD) multiple myeloma (MM) is a rare subtype of MM and commonly occurs in younger subjects but at a later stage of the International Staging System (ISS) when admitted. As a special type of IgD myeloma, IgD-λ/λ biclonal MM is rarer. Its serum protein electrophoresis and serum immuno-fixation electrophoresis (IFE) might find no anomalies even if the bone marrow (BM) examination is performed. Thus, it is easy to miss the diagnosis.CASE SUMMARYA 62-year-old man diagnosed as IgD-λ/λ myeloma (ISS stage III) was admitted with fatigue and weight loss. The physical examination suggested an anemic face, a few moist rales at the left lung base, and mild concave edema in both lower extremities. Laboratory examinations showed the elevated creatinine levels, β2-microglobulin, lactic dehydrogenase, and erythrocyte sedimentation rate, while the decreased neutrophils, granulocytes, and hemoglobin. In the serum protein electrophoresis, there appeared two inconspicuous M-spikes. Serum IFE indicated an over-representation of lambda light chain and yielded two monoclonal bands in λ region, but only one corresponding heavy chain band in the antisera to IgD region. The BM histology and BM cytology both supported the diagnosis of IgD-λ/λ myeloma.CONCLUSIONThis case highlights the differential clinical manifestations and laboratory findings of IgD-λ/λ myeloma to help minimize the chance of misdiagnosis.     

p38 activation in uninjured primary afferent neurons and in spinal microglia contributes to the development of neuropathic pain induced by selective motor fiber injury

Compelling evidence shows that the adjacent uninjured primary afferents play an important role in the development of neuropathic pain after nerve injury. The underlying mechanisms, however, are largely unknown. In the present study, the selective motor fiber injury was performed by L5 ventral root transection (L5 VRT), and p38 activation in dorsal root ganglia (DRG) and L5 spinal dorsal horn was examined. The results showed that phospho-p38 immunoreactivity (p-p38-IR) was increased in both L4 and L5 DRGs, starting on day 1 and persisting for nearly 3 weeks (P<0.05) following L5 VRT and that the activated p38 was confined in neurons, especially in IB4 positive C-type neurons. L5 VRT also induced p38 activation in L5 spinal dorsal horn, occurred at the first day after the lesion and lasted for 2 weeks (P<0.05). The activated p38 is restricted entirely in spinal microglia. In contrast, selective injury of sensory neurons by L5 dorsal root transection (L5 DRT) failed to induce behavioral signs of neuropathic pain and activated p38 only in L5 DRG but not in L4 DRG and L5 spinal dorsal horn. Intraperitoneal injection of thalidomide, an inhibitor of TNF-alpha synthesis, prevented p38 activation in DRG and spinal cord. Intrathecal injection of p38 inhibitor SB203580, starting before L5 VRT, inhibited the abnormal pain behaviors. Post-treatment with SB203580 performed at the 1st day or at the 8th day after surgery also reduced established neuropathic pain. These data suggest that p38 activation in uninjured DRGs neurons and in spinal microglia is necessary for the initiation and maintenance of neuropathic pain induced by L5 VRT.     

上海市两个社区成人血脂水平的横断面研究

目的评估上海市华阳、曹杨社区人群的血脂水平,描述血脂谱的人群流行特征。方法于1998年9月至2001年11月先后完成华阳、曹杨社区的5628例（20～95岁）调查对象代谢综合征的横断面调查。资料收集包括流行病学询问、体格检查和实验室血脂等指标的化验。以2000年全国人口构成为标准人口构成,计算两个社区成人血脂的标准化均数及标准化患病率。结果（1）标准化均数：华阳社区和曹杨社区成人TC,HDL-C,LDL-C和TG的标准化均数依次分别为5．01mmoL／L和4．43mmoL／L,1．28mmoL／L和1．32mmo]／L,3．37mmo]／L和2．99mmo]／L,1．97mmoL／L和1．60mmoL／L。（2）标准化患病率：按2005年6月16日上海血脂指南讨论会制定的血脂分层切点建议（2005）的划分标准,上海华阳、曹杨社区成人“血脂异常”的标准化患病率依次为52．9％和25．1％,“血脂边缘异常及异常”的标准化患病率分别为76．0％和56．2％。两社区“血脂异常”分类的标准化患病率从高到低依次均为：高TG血症、低HDL-C血症、高LDL-C血症和高TC血症。而华阳、曹杨“血脂合适范围”的标化百分构成从高到低均依次为TC、TG、LDL-C和HDL-C,其中HDL-C的百分构成远低于其他三项,仅为15．7％和16．1％。结论上海两社区成人“血脂异常”和“血脂边缘异常”的患病率均很高。人群血脂异常主要表现为高TG和低HDL-C。     

Expression of a novel alternatively spliced variant of NADP(H)-dependent retinol dehydrogenase/reductase with deletion of exon 3 in cervical squamous carcinoma

NADP(H)-dependent retinol dehydrogenase/reductase (NRDR) plays an important role in maintaining the homeostasis of retinoid. Aberrations in retinoid metabolism are considered as early events in carcinogenesis. We identified a novel alternatively spliced variant, NRDRB1, in HeLa cell and human cervical squamous carcinoma tissues, which is characterized by a complete deletion of exon 3. The latter resulted in changes in subcellular localization of NRDRB1 when compared with the peroxisomal localization of NRDR. To clarify the clinical significance of NRDRB1, we investigated its mRNA and protein expressions in normal cervical and cervical squamous carcinoma tissues, using RT-PCR, quantitative real-time PCR, Gateway expressing system, immunoprecipitation, immunoblotting, MALDI-TOF mass spectrometry and immunohistochemistry. We detected NRDRB1 mRNA in 14 of 26 (53.9%) cervical cancer tissues, but in none of the 12 normal cervical tissues. NRDRB1 protein was expressed in NRDRB1 mRNA-positive cases. While the full-length NRDR mRNA was observed in both normal and neoplastic cervical tissues, its protein was only expressed in normal cervical epithelium. The results presented here provide evidence that metabolic disturbances of retinal and retinoic acid, due to abnormal splicing and functional disorder of NRDR, may be involved in cervical tumorigenesis.     

罗格列酮对同型半胱氨酸硫内酯所致内皮细胞损伤的保护作用与PPARγ介导的抗氧化相关

目的探讨罗格列酮对同型半胱氨酸硫内酯(HTL)所致血管内皮细胞损伤的保护作用及其机制。方法在培养的人脐静脉内皮细胞(HUVEC),用HTL与HUVEC共孵,用罗格列酮、卡托普利、夹竹桃麻素、过氧化体增殖物激活型受体γ(PPARγ)拮抗剂GW9662、核因子κB(NF-κB)信号传导通路抑制剂吡咯二硫代氨基甲酸乙酯(PDTC)进行预干预,MTT比色法检测细胞活力,逆转录聚合酶链反应检测PPARγm RNA的表达,荧光探针DCFADA检测细胞内活性氧簇(ROS),免疫荧光检测法测定NF-κB P65,酶标法检测可溶性细胞间黏附分子1(s ICAM-1)。结果 HTL与HUVEC共孵育24 h,明显降低内皮细胞活力,增加细胞内ROS水平和NF-κB的活化,升高细胞培养液中s ICAM-1的浓度(P0.01)。罗格列酮(0.001、0.01、0.1 mmol/L)能浓度依赖性地拮抗HTL所致的内皮细胞活力降低,抑制细胞内ROS水平的增加和NF-κB的活化,降低细胞培养液中s ICAM-1的浓度,与单独HTL损伤组比较,差异有显著性(P0.05或P0.01)。上述保护作用可被选择性的PPARγ拮抗剂GW9662所拮抗。夹竹桃麻素、卡托普利、PDTC对HTL引起的上述指标改变也有明显改善作用。结论罗格列酮对HTL所致的HUVEC损伤有显著保护作用,其机制可能与PPARγ介导的氧化应激反应的抑制有关。     

IRAK-M在内毒素诱导Kupffer细胞耐受中的表达及其意义

目的:观察内毒素耐受状态TKupffer细胞中白介素-1受体相关激酶-M(IRAK-M)的表达并探讨其在Kupffer细胞内毒素耐受形成中的作用.方法:通过脂多糖(LPS,10μg/L)预处理建立内毒素耐受Kupffer细胞模型,并与对照组细胞进行比较;在LPS(100 μg/L)刺激后不同时点,用酶联免疫吸附试验(ELISA)检测细胞培养液中TNF-α水平,逆转录聚合酶链反应(RT-PCR)检测细胞中TNF-α和IRAK-M的mRNA表达,TransAM NF-kB Kit检测细胞中NF-kB活性,蛋白印迹法(Western blot)检测细胞中IRAK-M蛋白表达.结果:LPS刺激在两组细胞中均引起TNF-α释放增加.TNF-α mRNA表达以及NF-kB活性增强,但耐受组细胞的三种指标明显低于对照组(P＜0.05);对照组细胞在LPS刺激24 h后才能检测出IRAK-M mRNA的表达,而耐受组细胞在LPS刺激前已可检测到IRAK-M的基因表达,且该表达在LPS刺激后迅速增强,于6 h达高峰,24 h时仍明显高于对照组(P＜0.05);对照组细胞在LPS刺激24 h后才有微弱的IRAK-M蛋白表达,而耐受组细胞在LPS刺激前已有IRAK-M的蛋白表达,并随LPS刺激进一步上调,两组有显著差异(P＜0.01).结论:内毒素耐受状态下,Kupffer细胞中的IRAK-M表达明显增强,IRAK-M可能在Kupffer细胞内毒素耐受形成中起重要作用.     

苦参碱抑制SNL大鼠背根神经节TNF-α的表达

目的:观察苦参碱对脊神经损伤所致大鼠神经病理性疼痛的作用,并初步探讨其作用机制.方法:第1组实验将大鼠随机分为25 mg/kg、50 mg/kg、100 mg/kg和200 mg/kg剂量组,每组又分别随机分为实验组和对照组,实验组给予不同剂量苦参碱,对照组给予相应体积溶剂,各组大鼠于术后第8d利用行为学测试的方法,检测苦参碱对大鼠50％机械刺激撤足阈值及热刺激撤足潜伏期的影响.第2组实验将大鼠随机分为假手术组、模型组、25 mg/kg给药剂量组、50 mg/kg给药剂量组、100 mg/kg给药剂量组、200 mg/kg给药剂量组,实验组给予不同剂量溶剂,余组给予相同体积的溶剂.各组大鼠于第8d给药后3h,利用免疫组化的方法检测大鼠背根神经节TNF-α的表达.结果:50 mg/kg以上剂量苦参碱可显著提高模型大鼠50％机械刺激撤足阈值及热刺激撤足潜伏期,低于此剂量无效.50 mg/kg、100 mg/kg和200 mg/kg苦参碱对模型鼠50％机械刺激撤足阈值及热刺激撤足潜伏期提高作用可达6h以上.通过免疫组化结果可以看出,50 mg/kg、100 mg/kg和200 mg/kg苦参碱能够抑制背根神经节神经元内TNF-α的表达.结论:苦参碱可缓解腰5脊神经切断引起的神经病理性疼痛,其作用可能与抑制背根神经节内TNF-α的表达有关.     

心脏硫酸腺嘌呤预处理大鼠心肌微循环及胶原纤维的变化

目的：观察经典缺血预处理及硫酸腺嘌呤预处理大鼠心肌微循环及心肌问质胶原纤维的变化并探讨其意义。方法：大鼠分假手术组(S)、缺血再灌注组(1／R)、经典缺血预处理组(IPC)、硫酸腺嘌呤预处理组(ASP)，通过电镜二维图像立体计量法，测量心肌毛细血管横截面积，并观察问质胶原纤维的变化。结果：S组、IPC组与ASP组心肌毛细血管的横截面积显著大于I／R组。与I／R组相比较，IPC、ASP组心脏胶原纤维明显增加。结论：心脏经典缺血预处理与硫酸腺嘌呤预处理均能明显扩张心肌间质中血管及促进心脏胶原明显增多。4     

Naphthalimides Induce G2 Arrest Through the ATM-Activated Chk2-Executed Pathway in HCT116 Cells

Naphthalimides, particularly amonafide and 2-(2-dimethylamino)-6-thia-2-aza-benzo[def]chrysene-1,3-diones (R16), have been identified to possess anticancer activities and to induce G₂-M arrest through inhibiting topoisomerase II accompanied by Chk1 degradation. The current study was designed to precisely dissect the signaling pathway(s) responsible for the naphthalimide-induced cell cycle arrest in human colon carcinoma HCT116 cells. Using phosphorylated histone H3 and mitotic protein monoclonal 2 as mitosis markers, we first specified the G₂ arrest elicited by the R16 and amonafide. Then, R16 and amonafide were revealed to induce phosphorylation of the DNA damage sensor ataxia telangiectasia-mutated (ATM) responding to DNA double-strand breaks (DSBs). Inhibition of ATM by both the pharmacological inhibitor caffeine and the specific small interference RNA (siRNA) rescued the G₂ arrest elicited by R16, indicating its ATM-dependent characteristic. Furthermore, depletion of Chk2, but not Chk1 with their corresponding siRNA, statistically significantly reversed the R16- and amonafide-triggered G₂ arrest. Moreover, the naphthalimides phosphorylated Chk2 in an ATM-dependent manner but induced Chk1 degradation. These data indicate that R16 and amonafide preferentially used Chk2 as evidenced by the differential ATM-executed phosphorylation of Chk1 and Chk2. Thus, a clear signaling pathway can be established, in which ATM relays the DNA DSBs signaling triggered by the naphthalimides to the checkpoint kinases, predominantly to Chk2,which finally elicits G₂ arrest. The mechanistic elucidation not only favors the development of the naphthalimides as anticancer agents but also provides an alternative strategy of Chk2 inhibition to potentiate the anticancer activities of these agents.