B cell apoptosis accelerates the onset of murine lupus

To investigate whether the increased rate of lymphocyte apoptosis in systemic lupus erythematosus is involved in the onset of the disease, apoptotic or necrotic T or B lymphocytes from various cell lines were injected intraperitoneally into pre-autoimmune (NZBxNZW)F1 mice (BW) and non-autoimmune BALB/c mice. The intraperitoneal production of cytokines and chemokines, the specific T cell response in the spleen, and the production of anti-histone and anti-dsDNA Ab were investigated. The onset of the disease was characterized by creatinine levels and evaluation of glomerular IgG deposits. In BW, but not in BALB/c mice, injection of apoptotic and not necrotic cells up-regulated IL-6 and IL-10 in resident macrophages. Administration of apoptotic cells augmented the number of Th2 and B lymphocytes recruited in the peritoneal cavity. Only the treatment with apoptotic B cells promoted a systemic Th2 autoimmune response to H2 histones, associated with earlier occurrence of high levels of anti-dsDNA autoantibodies, higher creatinine levels and more numerous glomerular IgG deposits than in BW controls not injected with apoptotic B cells. In genetically susceptible mice exposure to apoptotic of B, but not T, lymphocytes can elicit a Th2 response to H2 histones that helps B cell production of anti-dsDNA Ab and finally triggers the onset of lupus.     

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??Value of preoperative lymphoscintigraphy in sentinel lymph node biopsy of breast cancer SUN Xiao*, LIU Juan-juan, WANG Yong-sheng, et al. *Breast Cancer Center, Shandong Cancer Hospital, Jinan 250117, China
Correcponding author: WANG Yong-sheng, E-mail: wangysh2008@yahoo.com.cn
Abstract Objectives Background Although preoperative lymphoscintigraphy for sentinel lymph nodes biopsy (SLNB) in breast cancer patients is undergone commonly, its clinical significance remains controversial. Methods Firstly, a database containing 716 consecutive breast cancer patients who received preoperative lymphoscintigraphy before SLNB was retrospectively analyzed. Secondly, 565 consecutive breast cancer patients were prospectively randomized into groups with or without preoperative lymphoscintigraphy before SLNB. Results In the retrospective study, sentinel lymph nodes (SLNs) were well imaged by lymphoscintigraphy in 86.6% patients, and negative lymphoscintigraphy results were associated with axillary node metastases. Failure of identification of SLNs by isotope alone was associated with whether axillary hot spot was imaged by lymphoscintigram (P<0.001). There were no significant differences in the false negative rate (P=0.731) of SLNB by isotope alone, in the identification rate (P=0.174) and the false negative rate (P=0.947) of SLNB by combination of dye and isotope between patients who had axillary hot spot in lymphoscintigram and those who had not. In the prospective study, 290 patients were randomized into the group with preoperative lymphoscintigraphy (82.1% patients were well imaged by lymphoscintigraphy) and 275 patients without. There were no significant differences between two groups in the identification rate (P=0.757) and the false negative rate (P=1.00) of SLNB by isotope alone, also in the identification rate (P=1.00) and the false negative rate (P=1.00) of SLNB by combination of dye and isotope. Conclusion Preoperative lymphoscintigraphy could not improve the identification rate and reduce the false negative rate of SLNB in breast cancer patients, and it is not a prerequisite for SLNB.     

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??Cathepsin-D and nm23 provide the predictive value of response to anthracycline-based neoadjuvant chemotherapy in breast cancer CHEN Yi-zuo*, CHEN Can-ming, FEI Fei, et al. *Department of Breast Surgery?? Cancer Hospital??Fudan University.Department of Oncology, Shanghai Medical College, Fudan University,Shanghai 200032??China Corresponding author: WU Jiong, E-mail: wujiong1122@vip.sina.com Abstract Objective To investigate the predictive value of biological markers for responsiveness to anthracyline-based regimen in neoadjuvant systemic therapy. Methods Post-operative paraffin-embedded tumor samples from 173 breast cancer patients were examined for expression of ER??PR??Her-2/neu??and other 15 markers by immunohistochemistry, to analyze the predictive value of these biological markers for response to neoadjuvant chemotherapy. Results For the primary tumor, the clinical objective response was 66.47%?? 29.48%SD,and 4.05% PD. Pathological complete response was found in 3 cases(1.73%).Negative nm23, and loss of Cathepsin-D were significantly predictive for an effective response to anthracycline-based neoadjuvant chemotherapy. In multivariate logistic regression analysis, only the Cathepsin-D status was found for independent predictive value. Conclusion Loss of Cathepsin-D independently predicts the response to anthracycline-based regimen.     

RNA versus DNA (NucliSENS EasyQ HIV-1 v1.2 versus Amplicor HIV-1 DNA test v1.5) for early diagnosis of HIV-1 infection in infants in Senegal

The objective of this study was to compare the performance of the NucliSENS EasyQ HIV-1 v1.2 platform (bioMérieux, France) to the Amplicor HIV-1 DNA test v1.5 (Roche Molecular Systems, Switzerland) in detecting HIV-1 infection in infants using venipuncture-derived whole blood in tubes and dried blood spots. A total of 149 dried blood spots and 43 EDTA-anticoagulated peripheral blood samples were collected throughout Dakar and other areas in Senegal from infants and children aged 3 weeks to 24 months who were born to HIV-1-infected mothers. Samples were tested using the NucliSENS and Amplicor technologies. The NucliSENS and Amplicor results were 100% concordant using either EDTA-anticoagulated peripheral blood or dried blood spots. Compared to Amplicor, the sensitivity and specificity of the NucliSENS test were 100%. The NucliSENS EasyQ HIV-1 RNA assay performed as well as the Amplicor HIV-1 DNA test in detecting HIV-1 infection in infants. In addition, this platform can give an indication of the viral load baseline. The NucliSENS EasyQ platform is a good alternative for early infant diagnosis of HIV-1 infection.     

宫腔镜术中严重气体栓塞相关因素研究

目的 探讨宫腔镜手术中发生循环气体栓塞（气栓）的相关因素及症状出现的原因。方法 观察郑州大学人民医院2010-08-04至2010-12-31收治的34例宫腔镜手术患者,采用超声多普勒监测循环中气栓的情况,并进行分级;分析不同级别气栓、手术时间、灌注量、单双极电切与临床症状或体征出现的关系。结果 34例患者中发现循环气栓20例,出现症状6例,无气栓者无症状出现;Ⅱ级气栓5例,出现症状2例,Ⅲ级气栓6例,出现症状4例,症状出现与气栓级别呈正相关;手术时间＞30 min者26例,气栓18例,出现症状6例,气栓级别及临床症状率均显著增加;灌注量＞3000 mL 20例,气栓15例,出现症状4例,随灌注量增多,气栓及临床症状出现例数明显增多,差异有统计学意义;单极电切20例,发现气栓12例,出现症状5例;双极14例,发现气栓8例,出现症状1例,发现气栓及出现症状差异无统计学意义。结论 宫腔镜手术临床症状与气栓关系密切,低级别气栓对机体无严重损伤。气栓分级可以预测严重并发症的出现,气栓的等级与临床症状的出现有相关性。     

大鼠股骨缺损模型中BBP增强BMP-2的骨诱导作用*

目的验证在大鼠节段性骨缺损模型中骨形态发生蛋白结合肽（BMP Binding Peptide,BBP）对于重组人骨形态发生蛋白-2（recombinent human bone morphogenetic protein-2,rhBMP-2）骨诱导作用的影响。方法 70只缺损大鼠分别分成7组,每组不同剂量的rhBMP-2＋/-1000 gBBP,4w和8w后分别摄片,动物8w后处死,股骨样本分别手工评估,采用uCT测量骨容积,随后分别采用组织学和生物力学分析。结果高剂量（10 g）rhBMP-2组术后8w可见骨愈合,骨缺损处骨完全覆盖和桥接,但低剂量（5 g和2 g）rhBMP-2组术后8w骨愈合欠佳。与单独应用rhBMP-2相比,使用低剂量的rhBMP-2复合一定量的BBP可以取得更满意的骨形成量。BBP增强rhBMP-2的骨形成活性发生于4~8w时,而在术后早期并无明显作用。单纯应用BBP仅可见骨缺损处局部的钙化,未见骨愈合。结论 BBP能显著增强rhBMP-2的骨形成活性,这种增强作用需要一定时间来产生效果;其活性发生于术后4~8w时,在术后早期并无明显作用。而且BBP本身并没有骨诱导潜力,仅仅能增强rhBMP-2的骨形成活性。BBP起到缓释作用,与rhBMP-2紧密结合后,让rhBMP-2缓慢而持久的释放。     

Age-related progression of tau pathology in brains of baboons

Recently, cytoskeletal changes associated with abnormally phosphorylated tau protein were demonstrated in neurons and glial cells of two aged baboons (Papio). The present study examines the effects of age on the development of tau pathology in baboons. Brains of 50 baboons ranging in age from 1 to 30 years were categorized into four age groups: Group I: 1–10 years [n = 9], group II: 11–20 years [n = 13], group III: 21–25 years [n = 17], group IV: 26–30 years [n = 11]). Whole hemisphere sections (100 μm) were examined using phosphorylation-dependent anti-tau antibodies. Cytoskeletal changes were completely absent in animals of group I. In group II four animals (31%) exhibited cytoskeletal changes which were rated as mild or moderate. In group III abnormal tau was found in 12 brains (71%) ranging in severity from mild to severe. Finally, in group IV 10 out of 11 animals (91%) exhibited some degree of tau pathology which was rated as severe in 4 animals (36%). A statistically significant relationship was found between advancing age and progression of tau pathology in baboons. In conclusion, the present findings underline the value of the baboon as a potential nonhuman primate model for age-related tau pathology afflicting the human brain.     

胆道术后严重大出血54例临床分析

目的 分析胆道术后严重出血的临床病程和治疗效果。方法 回顾性分析2016-2018年海军军医大学附属东方肝胆外科医院胆道外科行手术治疗的胆道疾病病人中需要行介入治疗（内镜和血管造影治疗）或再次手术的严重大出血者54例临床资料。结果 胆道术后严重出血的发生率为1.7%（54/3183）。胆道术后严重出血相关的总体死亡率为0.53%（17/3183）。54例病人中,有3例行内镜检查,仅1例行内镜治疗成功止血;34例接受介入血管造影检查的病人中,23例接受了介入性栓塞治疗（包括介入性钢圈栓塞、覆膜支架等血管介入治疗）,18例止血成功,成功率为78.3%（18/23）。35例行再次剖腹止血手术,其中19例将手术作为一线治疗方案,16例为内镜或介入治疗失败后行补救性治疗。结论 胆道术后严重出血原因较多,临床表现多样,早期发现和治疗至关重要。应综合考虑发病时间、伴发并发症情况和初次手术方案制定治疗决策。介入治疗临床安全性和止血成功率较高,但在介入治疗止血失败的情况下应紧急中转手术治疗。