Causes of death in primary plasma cell leukemia differ from multiple myeloma: A STROBE-compliant descriptive study based on SEER database

The primary plasma cell leukemia (pPCL) is a rare but aggressive variant of multiple myeloma (MM). Few studies have focused on the differences in the causes of death between pPCL and MM. This study aimed to compare and evaluate the causes of death of patients with pPCL and MM.The data were collected from the Surveillance Epidemiology, and End Results (SEER) database. The demographic characteristics, survival, and causes of death in pPCL and MM patients were evaluated and compared. The competing risk regression model was performed to predict the cause of death.Between 1975 and 2009, the overall mortality rate was 96.13% and 88.71% for pPCL and MM, and the median survival was 9 and 26 months, respectively. In pPCL, leukemia caused 45.05% of the deaths, followed by myeloma (38.83%). In MM, myeloma was the leading cause of death, accounting for 74.89% of the deaths. Older age at diagnosis was a risk factor for dying of leukemia in pPCL patients (HR = 1.49, 95% CI: 1.16–1.91), while older age at death was associated with reduced risk (HR = 0.67, 95% CI: 0.52–0.86). Although the survival of pPCL patients increased with time periods of diagnosis since 1975 to 2009, the risk of dying of leukemia increased with the periods. For MM, most of the demographic characteristics were found to have independently predicting influence on the cause of death.Patients with pPCL and MM had distinct causes of death. Leukemia was the leading and the most serious cause of death in pPCL patients. The demographic factors could not predict the causes of death in pPCL. More large-scale and multi-center studies are needed to evaluate the effect of novel agents in pPCL patients, especially for patients who have progressed to leukemia.     

异种(牛)脱细胞真皮基质-游离空肠复合体构建实验研究

目的 研究异种(牛)脱细胞真皮基质-游离空肠复合体的构建技术,以期解决游离空肠移植重建长段气管术后肠腺分泌的问题。 方法 选择10只杂种犬,制备去上皮游离空肠段,将剪成合适大小的异种(牛)脱细胞真皮基质覆盖于游离空肠基底膜表面,并用覆膜镍钛合金支架支撑固定,将构建好的复合体移至腹膜外与腹部皮肤之间,分别于术后7 d、14 d、1个月、3个月和6个月后取出,查看复合体的生长情况。 结果 10只实验犬中,有1只因肠粘连和伤口感染死亡而未能完成实验,余9只实验犬术后存活良好。术后7 d、14 d肉眼观察和病理检查,在游离空肠内表面均见有异种(牛)脱细胞真皮基质成分,表面黏膜层可见部分鳞状上皮化生;术后1个月、3个月、6个月肉眼和病理检查均未再发现异种(牛)脱细胞真皮基质成分,游离空肠内表面几乎全部化生为复层鳞状上皮。 结论 合适大小的异种(牛)脱细胞真皮基质覆盖在去上皮游离空肠内表面,可以促进游离空肠内表面的鳞状上皮化生,抑制肠腺分泌。覆膜镍钛记忆合金支架有一定的弹性,可以很好的对异种(牛)脱细胞真皮基质-去上皮游离空肠复合体起到支撑固定作用。     

脑源性神经营养因子和神经生长因子对顺铂诱导的内耳毒性的保护作用

目的研究豚鼠耳蜗内脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)和神经生长因子(nerve growthfactor,NGF)在顺铂致耳中毒后的表达,并探讨其对内耳的保护作用。方法将豚鼠分成对照组、顺铂组,分别给生理盐水、顺铂腹腔注射,于注射后3、5、7天取豚鼠耳蜗行石蜡切片,进行BDNF和NGF免疫组织化学染色,观察螺旋神经节BDNF和NGF蛋白表达。结果对照组耳蜗螺旋神经节细胞中BDNF几乎不表达,NGF呈中度阳性表达。顺铂组BDNF在3天时达到高峰,以后减弱;NGF在5天时达到高峰,以后减弱。结论正常豚鼠耳蜗有中度NGF的表达,表明NGF可能对内耳的正常生理功能起重要作用。顺铂干预后螺旋神经节BDNF和NGF出现高表达,提示BDNF和NGF对顺铂诱导的螺旋神经元损伤有保护作用。     

抗眼组织纤维化药物的研究进展

纤维化是许多眼科手术失败的主要原因之一，应用抗纤维化药物能提高手术的成功率。如：5—氟尿嘧啶、丝裂霉素C、组织型纤溶酶原激活剂等已用于实验和临床研究，本文重点提出转化生长因子—β抑制剂核心蛋白多糖(Decorin)有可能作为抗眼组织纤维化的药物。     

近红外光谱法快速测定山银花中四种有机酸

目的：建立近红外光谱（Near-Infrared Spectroscopy,NIR）快速检测山银花提取过程中四种有机酸含量的方法。方法：采集山银花NIR图谱,以高效液相色谱法为参考方法测定绿原酸、异绿原酸A、异绿原酸B和异绿原酸C的含量。采用偏最小二乘法（Partial Least square,PLS）建立定量校正模型。结果：校正模型中绿原酸、异绿原酸A、异绿原酸B和异绿原酸C的相关系数R分别为0.997 6、0.997 0、0.979 2、0.998 9,内部交叉验证均方根误差（RMSECV）分别为0.039 4、0.014 4、0.007 3、0.007 8;预测结果中上述成分对应的相关系数分别为0.892 0、0.827 9、0.878 4、0.995 1,预测均方根误差（RMSEP）分别为0.045 0、0.013 5、0.007 8、0.008 0,相对预测 偏差（RSEP）分别为0.351 0%、0.018 0%、0.040 0%、0.005 7%。结论：所建近红外检测方法快速、准确,可用于山 银花四种有机酸的快速检测。     

胰腺癌CT临床分析(附31例报告)

对31例胰腺癌和其它胰腺病变术前CT误诊和漏诊病例进行回顾性分析。结果误诊25例，其误诊率为44．0％（11／25）。主要原因：一是CT表现不典型；二是对某些CT征象认识不足以及分析欠全面。漏诊6例，主要为胰头部直径≤3cm的小胰头癌。通过对误诊、漏诊原因的分析，作者认为，改进检查技术，如采用薄层连续动态CT扫描，结合临床资料对CT征象作全面分析及综合多种影像学方法优势，可减少误诊、温沙机率。     

Evaluation of protective effects of Chi-Zhi-Huang decoction on Phase I drug metabolism of liver injured rats by cocktail probe drugs

AIM OF THE STUDY: Chi-Zhi-Huang decoction (PGR) is one of the traditional Chinese medicine (TCM) preparations with unique effect on withdrawing jaundice and has been used to treat icteric patients in China for many years. In this research, we aim at to evaluate the potential activity of PGR in restoring hepatic drug metabolism in a damaged liver. MATERIALS AND METHODS: A cocktail approach with caffeine (10mg/kg), dapsone (10mg/kg) and chlorzoxazone (20mg/kg) respectively as probe drug of cytochrome P450 (CYP) isoform of CYP 1A2, 3A4 and 2E1 was used to evaluate its possible effects on Phase I oxidative metabolism. Pretreated with three dosages of PGR water extract (0.75, 1.5 and 3g/kg, po) for 5 days, male Wistar rats (220-240 g) were intoxicated by phenylisothiocyanate (PITC, 100mg/kg, po) 24h before probes intravenous injection. The pharmacokinetics of the probes in the blood was determined simultaneously by HPLC, and their non-compartmental parameters were used to evaluate the metabolic difference among the groups. Moreover, the levels of liver enzymes (ALT, AST, ALP) and bilirubins were also measured for insight of liver function. RESULTS: The findings in this study suggest that PGR induces CYP 3A4, does not have much effect on CYP 2E1, and inhibits CYP 1A2 at high dosage. CONCLUSION: The current pharmacokinetic approach allowed the protective effects of PGR on oxidative drug metabolism in damaged liver to be systemically examined and will certainly help in the explanation of synergistic effect of the composites formula.     

Proteomic studies of early-stage and advanced ovarian cancer patients

ObjectivesThe objectives of this study were to evaluate the diagnostic value for ovarian cancer using proteomic pattern established by surface-enhanced laser desorption/ionization (SELDI-TOF-MS) profiling of plasma proteins coupled with support vector machine (SVM) data analysis, and to investigate whether the proteomic pattern established by advanced ovarian cancer could be used for diagnosis of early-stage ovarian cancer patients.MethodsThe study included 44 ovarian cancer patients (11 early-stage and 33 advanced ovarian cancer patients) and 31 age-matched non-cancer controls. SELDI-TOF-MS coupled with SVM analysis was performed to establish a proteomic pattern to discriminate 33 advanced ovarian cancer patients from 31 non-cancer controls. A blind test, including 11 early-stage ovarian cancer cases, was performed to investigate whether proteomic pattern established by advanced ovarian cancer could be used for diagnosis of early-stage ovarian cancer patients.ResultsA seven-peak proteomic pattern was established which discriminated 33 advanced ovarian cancer patients from 31 non-cancer controls effectively. A sensitivity of 93.94% (31/33) and a specificity of 93.55% (29/31) were yielded from the proteomic pattern. Among the 7 protein peaks, 5 with mass charge ratio (m/z) 4099 Da, 5488 Da, 4144 Da, 4479 Da and 3940 Da were up-regulated, while 2 peaks, with m/z 13 783 Da and 8588 Da were down-regulated in the advanced ovarian cancer group compared with non-cancer control group. After blind test, 9 of 11 early-stage ovarian cancer patients were successfully diagnosed with the accuracy of 81.82% (9/11).ConclusionsThis study demonstrated that SELDI-TOF-MS coupled with SVM is effective in distinguishing protein expression between ovarian cancer and non-cancer plasma and it may be feasible to diagnose early-stage ovarian cancer using proteomic pattern established by advanced ovarian cancer. The gained and lost protein peaks in plasma may exist in both early-stage and advanced ovarian cancer plasma. Further studies should be performed using larger sample numbers.     

Fetal cardiac malposition: incidence and outcome of associated cardiac and extracardiac malformations

Cardiac malposition is a rare but important finding when detected on fetal ultrasound. The purpose of this study was to evaluate the incidence of fetal cardiac malposition, associated abnormalities, and clinical outcome in a tertiary-care medical center. Records of fetuses (1993 to 2006) with dextroposition, dextrocardia, mesocardia, ectopia cordis, or heterotaxy were reviewed. The presence of congenital heart disease (CHD), extracardiac anomalies, and outcome were noted. Cardiac malposition was present in 101 fetuses among a total of 3313 (3%) pregnancies. In 78 (78%) patients, the heart was positioned in the right hemithorax. Of those, 26 (33%) had dextrocardia (CHD = 21), and 52 (67%) had dextroposition (CHD = 14). Sixteen (16%) patients had mesocardia (CHD = 8), and 7 (7%) had ectopia cordis (CHD = 6). The majority (58%) of fetal cardiac malposition was caused by intrathoracic masses. Concomitant CHD occurred in 50%. Outcome was available in 97%. The perinatal and neonatal mortality rate was 30%; the elective termination rate was 4%. Patients with CHD had higher mortality rates. The highest mortality rates occurred in ectopia cordis and combined disease of diaphragmatic hernia and CHD.