Prognostic value of serial CA125 measurements during chemotherapy for patients with advanced ovarian cancer

Serum CA125 concentrations measured before and during chemotherapy may provide additional information for prognostic assessment of patients with epithelial ovarian cancer (EOC), and enable discrimination between patients who are likely to benefit from further therapy and those who will not. Medical records of 40 patients with advanced EOC, treated at the Department of Obstetrics and Gynecology of the University Hospital Nijmegen between July 1984 and April 1993, were examined. All patients had primary cytoreductive surgery followed by platinum-based chemotherapy. Serum samples were obtained before surgery and during chemotherapy. Follow-up information and patient and tumor characteristics were abstracted from medical records until December 1, 1994. By using multivariate Cox proportional hazards models for disease-free and overall survival it was evaluated whether outcome prediction was improved by inclusion of serum CA125 quantitations.
  Only FIGO stage and extent of residual tumor were significant independent prognostic factors before the start of chemotherapy. When such regression models were constructed after subsequent courses of chemotherapy, serum CA125 measurements conducted after each of the first three chemotherapy courses improved the prediction of disease-free survival. Prediction of overall survival was improved by inclusion of serum CA125 measurements after courses 1–6. Inclusion of serum CA125 measurements during chemotherapy improved prognostic assessment of patients with advanced EOC.     

Diagnosis of ectopic pregnancy after in vitro fertilization and embryo transfer

Objective: The combination of transvaginal sonography and serum hCG measurement is reliable in the diagnosis of ectopic pregnancy (EP) in spontaneous pregnancies. In patients who became pregnant through IVF-ET, transfer of multiple embryos after IVF could be responsible for the different performance of these tests. We evaluated the discriminative capacity of transvaginal sonography in combination with hCG measurement in the diagnosis of EP after IVF-ET.

Design: Prospective cohort study.

Setting and Patient(s): Consecutive patients, pregnant through IVF-ET, who presented with clinically suspected EP.

Intervention(s): Transvaginal sonography, serum hCG measurement at 6, 9, and 15 days after ET and after a negative transvaginal sonography.

Main Outcome Measure(s): Ectopic pregnancy confirmed at laparoscopy.

Result(s): Between September 1993 and May 1996, 86 women were included in the study, of whom 24 had an EP. Transvaginal sonography identified 46 intrauterine pregnancies and 5 EPs, but serum hCG could not diagnose EPs in patients in whom transvaginal sonography did not show a gestational sac. Serum hCG measurement 9 days after ET could identify pregnancy failure with 100% specificity at a cut-off value of 18 IU/L, but it could not identify patients with EP with enough certainty to justify immediate treatment.

Conclusion(s): We recommend single serum hCG measurement 9 days after ET to discriminate between viable and nonviable pregnancies. Transvaginal sonography can be postponed until 5 weeks after ET, except for patients with abdominal pain and/or vaginal bleeding, or patients with a serum hCG level of <18 IU/L.     

妊娠期糖尿病孕妇与正常孕妇血清铬含量的研究

目的　通过对血清铬含量的测定 ,探讨妊娠期糖尿病孕妇是否缺铬。方法　 2 0 0 0～ 2 0 0 1年 ,选择妊娠期糖尿病孕妇 5 0例 ,正常孕妇 4 7例 ,以电感耦合高频等离子体发射光谱法 (ICP AES)测定两组孕妇血清铬含量。结果　妊娠期糖尿病孕妇血清铬含量较正常孕妇明显降低 ,差异有显著性意义 (P <0 0 5 )。结论　建议妊娠期糖尿病孕妇适量补铬     

窒息新生儿脐血神经肽Y含量变化及意义

目的　探讨神经肽Y(neuropeptideY ,NPY)与新生儿窒息的关系。　 方法　采用放射免疫法测定 37例有新生儿窒息孕妇 (窒息组 )及 33例正常妊娠妇女 (对照组 )静脉血及脐血中NPY含量。　结果　 (1)窒息组脐血中NPY含量为 (187.4 7± 4 6 .6 3)ng/L ,对照组为 (115 .33±2 9.4 2 )ng/L。两组比较差异有显著性 (t =3.113,P <0 .0 1) ,重度窒息组与轻度窒息组间差异也有显著性(t=2 .0 0 1,P <0 .0 5 )。 (2 )窒息组母血浆NPY含量为 (78.94± 19.5 2 )ng/L ,对照组为 (85 .73±2 2 .95 )ng/L ,两组间差异无显著性 (t =1.72 1,P >0 .0 5 ) ,且轻、重度窒息组间差异也无显著性 (t =1.5 12 ,P >0 .0 5 )。(3)窒息组脐动脉血血气分析 :pH为 (7.0± 0 .1) ,PO2 为 (1.2± 0 .3)kPa ,PCO2为 (8.9± 0 .8)kPa ;NPY水平与脐血pH及PO2 显著负相关 (r =- 0 .4 5 1及 - 0 .4 92 ,P <0 .0 1) ,与PCO2 显著正相关 (r =0 .4 38,P <0 .0 1)。两组母血NPY水平无差异。　结论　NPY参与了新生儿窒息的病理变化过程 ,与新生儿窒息的发生发展密切相关。     

妊娠期糖尿病母儿血清瘦素水平及胎盘瘦素的表达

目的　探讨妊娠期糖尿病 (gestationaldiabetesmellitus ,GDM)母儿血清瘦素水平及胎盘瘦素表达的变化。　方法　采用放射免疫法 (RIA)检测 2 4例GDM母儿和 2 6例正常母儿血清胰岛素和瘦素水平 ,采用逆转录 聚合酶链反应 (RT PCR)技术检测胎盘瘦素mRNA的表达水平。　结果　 (1)GDM组孕妇血清瘦素和胰岛素水平分别为 (18.6 2± 7.86 ) μg/L和 (13.4 7± 5 .11)mIU/L ,对照组分别为 (14 .2 1± 7.5 9) μg/L和 (8.98± 4 .2 3)mIU/L ,两组比较差异有显著性 (P <0 .0 5 )。 (2 )GDM组脐血瘦素和胰岛素水平分别为 (17.93± 6 .14 ) μg/L和 (19.2 6± 6 .73)mIU/L ,对照组分别为 (7.2 7± 4 .32 ) μg/L和 (9.6 7± 4 .89)mIU/L ,两组比较差异有显著性 (P <0 .0 1)。 (3)两组孕妇血清瘦素与胰岛素水平之间无相关关系 (r =0 .2 2 ,P >0 .0 5 ) ,而脐血血清瘦素与胰岛素水平之间呈正相关关系(r =0 .5 3,P <0 .0 1)。 (4 )GDM组胎盘瘦素mRNA表达水平为 (1.92± 0 .0 5 ) ,对照组为 (0 .97± 0 .0 2 ) ,两组比较差异有显著性 (P <0 .0 1)。　结论　胰岛素及瘦素抵抗可能是妊娠期糖尿病的发病原因之一 ,胰岛素对调节胎盘瘦素的表达起重要作用。     

植物雌激素两种单体对子宫内膜腺上皮细胞作用的比较

目的 探讨植物雌激素两种单体在浓度5～80μmol／L对人子宫内膜腺上皮细胞增殖的影响。方法 2003年8～12月应用胶原酶阶梯消化法，原代培养人子宫内膜腺上皮细胞，用MTT方法观察植物雌激素的主要成分金雀黄素和大豆甙元对细胞体外增殖的影响。结果 低浓度的大豆甙元能促进子宫内膜腺上皮细胞轻度生长．随浓度的增加其作用明显，但当浓度达到40μmol／L，抑制细胞生长；不同浓度的金雀黄素均抑制子宫内膜腺上皮细胞的增殖。结论 植物雌激素两种单体对人子宫内膜腺上皮细胞的作用是明显不同的，提示在应用植物雌激素时要考虑不同成分的差别?     

母源性BDE-209胃灌后对子鼠学习记忆能力的影响以及血清BDE-209浓度的测定

目的研究母鼠在妊娠期及哺乳期接触十溴联苯醚(brominated diphenyl ethers-209,BDE-209)对子鼠的学习记忆能力的影响以及血清BDE-209的浓度测定。方法通过胃灌的方法造成Wistar大鼠BDE-209[300mg/(kg.d)]的暴露模型,直至生育出的子鼠断乳,通过Y型迷宫测试子鼠的学习记忆能力。然后分别取母鼠及子鼠的血清进行BDE-209的测定。结果终生胃灌BDE-209组的大鼠学习能力为89.65±6.68,记忆能力为平均为4.75±1.25,均较对照组(学习能力68.85±9.28,记忆能力8.05±0.76)有明显的下降,差异有统计学意义(P<0.01);妊娠期以及哺乳期均胃灌组学习能力为74.40±8.26,较正常对照组有下降,差异有统计学意义(P<0.05),但记忆能力下降差异无统计学意义(P>0.05);单纯哺乳期胃灌组较对照组学习记忆能力下降差异无统计学意义(P>0.05);母鼠血清中BDE-209的含量与子鼠正相关。结论BDE-209可以通过胎盘屏障以及母乳进入胎鼠体内并有一定程度的蓄积,并且可以影响发育中的子鼠神经系统,降低子鼠的学习记忆能力检测。     

IL-6 receptor blockade ameliorates diabetic nephropathy via inhibiting inflammasome in mice

Background and ObjectiveInterleukin 6 (IL-6) has been identified as a key mediator in inflammation, immune responses and glucose metabolism. In this study, we assessed the effects of an IL-6 receptor antibody on diabetic nephropathy in a mouse model of type 2 diabetes mellitus.MethodsTwelve week old male db/db mice were treated with Tocilizumab (an IL-6 receptor antibody), normal IgG1 control antibody, insulin or normal saline for 12 weeks. Renal injury, inflammation and insulin resistance were assessed.ResultsDb/db mice treated with Tocilizumab exhibited reduced proteinuria and glomerular mesangial matrix accumulation compared to db/db + IgG controls. Additionally, Tocilizumab suppressed inflammatory response, oxidative stress and the IL-6 signaling pathway in the diabetic kidneys. It is noteworthy that blockade of IL-6 receptor blunted the activation of NLRP3 inflammasome partly through inhibition of IL-17A. Furthermore, insulin resistance assessed by glucose tolerance test, was ameliorated by Tocilizumab treatment.ConclusionsThe protective effects of an IL-6 receptor blockade against diabetic renal injury may be due to decreased insulin resistance and inhibition of the inflammasome.     

Allostatic load and women’s brain health: A systematic review

Allostatic load represents the ‘wear and tear’ of chronic stress on the brain and body that may differ between men and women. A small but growing number of studies are assessing allostatic load in relation to mental health. The objective of this systematic review was to (1) assess sex differences in allostatic load and (2) identify allostatic load associations that are specific to women. We systematically searched for allostatic load studies that included psychosocial causes and/or psychiatric consequences. Our search focused on allostatic load studies that disaggregated by sex and that include women. Sixty-two studies were included in this systematic review. First, men appear to have higher allostatic load than women. Second, women show gender-specific variation for numerous factors such as age, race/ethnicity, adversities, social support, and health behaviors that influence associations between allostatic load and mental health. Recommendations are made to guide researchers advance sex and gender approaches.