抗磷脂抗体与恶性肿瘤相关易栓症

抗磷脂抗体（antiphospholipid antibody,aPL）是一组与各种带阴电荷磷脂抗原发生反应的多种抗体的总称,包括狼疮抗凝物（lupus anticoagulant,LA）、抗心磷脂抗体（anticardiolipin antibodies,aCL）、抗磷脂酸抗体以及抗磷脂酰丝氨酸抗体等.血液中高滴定度的aPL是抗磷脂综合征（antiphospholipid syndrome,APS）反复的动静脉血栓形成的极其关键的因素.正常健康人aPL的检出率大约为4.5％ ～9.4％.     

Place de l’Activité Physique Adaptée dans le parcours de soins : cas du patient présentant une stéatose hépatique non-alcoolique (NAFLD)

Non-Alcoholic Fatty Liver Disease (NAFLD) is estimated to affect 26% of men and 11% of women in France. NAFLD is a continuum of liver damage ranging from, simple steatosis, to non-alcoholic steatohepatitis (NASH), NASH with liver fibrosis and sometimes post-NASH cirrhosis. NAFLD is favored by excess weight (overweight or obesity) associated with systemic metabolic abnormalities affecting particularly, adipose tissue and striated muscles. The preventive and curative treatment of NAFLD is based on hygienic and dietary measures. These measures have proven to be effective in terms of resolution of NASH and stabilization or even regression of liver fibrosis. The implementation of a program of adapted physical activity (APA), by a competent professional, contributes significantly to the improvement of the clinical state independently of weight loss. At the molecular level, the current literature emphazises the pleiotropic effect of this management, particularly through its direct or indirect action on local (e.g. hepatic) and systemic metabolism, the systemic inflammatory state and rheological activity. Beyond these pathophysiological repercussions, the APA professional accompanies the patient with a chronic disease, in this case NAFLD, to induce a sustainable lifestyle change by focusing on his or her motivational state. These measures appear to be beneficial for both adults and children.     

Postoperative morbidity and mortality after anterior resection with preventive diverting loop ileostomy versus loop colostomy for rectal cancer: A updated systematic review and meta-analysis

The purpose of this meta-analysis was to evaluate the perioperative morbidity after anterior resection with diverting loop ileostomy (LI) versus colostomy (LC) and its reversal for rectal cancer. The studies on the application of loop ileostomy versus loop colostomy in anterior resection published from January 2000 to January 2020 were searched in the databases of Pubmed, Embase, Cochrane library, and Clinical trials. All randomized controlled trials (RCTs) and cohort studies were included according to inclusion criteria. Eight studies (2 RCTs and 6 cohort studies) totaling 1451 patients (821 LI and 630 LC) were included in the meta-analysis. The morbidity related to stoma formation and closure did not demonstrate significant differences. Significantly more LCs were complicated by stoma prolapse & retraction (OR:0.26,95%CI:0.11–0.60,P = 0.001), parastomal hernia (OR = 0.52,95%CI:0.30–0.88, P = 0.01), surgical site infection (SSI) (OR = 0.24,95%CI:0.11–0.49,P < 0.0001) and incisional hernias (OR = 0.39,95%CI:0.19–0.83,P = 0.01) than by LIs. Patients with LI demonstrated significantly more complications related to the stoma, such as dehydration (OR = 0.52,95%CI:0.30–0.88, P = 0.01) and ileus (OR = 2.23,95%CI:1.12–4.43, P = 0.02) than patients with LC. While after the subgroup analysis of different publication years, LI could reduce the risk of the morbidity after stoma formation in previous years group (P = 0.04) with a lower heterogeneity (I² = 37%); LC could reduce the incidence of parastomal dermatitis in recent years group (P < 0.0001) without heterogeneity in each subgroup (I² = 0%). Cumulative meta-analysis detected significant turning points in dehydration, SSI, and ileus. This meta-analysis recommends diverting LI in the anterior resection for rectal cancer, but there is a risk of dehydration, irritant dermatitis, and ileus.     

Twist和Snail在乳腺癌中的表达及其与血管生成的关系

目的:探讨Twist和Snail蛋白在乳腺癌组织中的表达及其与微血管密度的关系。方法:应用免疫组织化学法检测80例乳腺癌组织Twist、Snail蛋白的表达情况。CD34抗体标记乳腺癌血管内皮细胞,计算微血管密度(MVD)。结果:乳腺癌组织中Twist的阳性表达率为67.5%(54/80),Snail的阳性表达率为72.5%(58/80),Twist、Snail阳性组MVD显著高于Twist、Snail阴性组,P<0.05。在乳腺癌组织中Twist、Snail蛋白的表达之间存在显著正相关,r=0.529,P<0.01。结论:乳腺癌组织中存在Twist、Snail蛋白的高表达,两者的联合表达能增加肿瘤细胞侵袭力,促进乳腺癌的浸润、转移,联合检测有助于判断患者的预后。     

Prognostic Markers in Resected Non–Small-Cell Lung Cancer: An Patients with 5 Year Follow-Up

We performed a retrospective analysis of potential prognostic markers in 260 patients with surgically resected stage I and II non–small-cell lung cancer (NSCLC) with a minimum 5-year follow-up. Cox proportional hazard models and Wilcoxon tests were employed to analyze the effect of patient characteristics on survival and disease-free survival (DFS). In the univariate analysis, the following were significant predictors of shorter overall survival: N-stage (N1 vs N0) (p < 0.001); T-stage (T2 vs T1) (p < 0.001); antigen A (loss vs presence) (p < 0.01); cough (present vs absent) (p= 0.01); bcl-2 expression (positive vs negative) (p= 0.03); age (> 63.5 vs < 63.5) (p= 0.03); mucin (positive vs negative) (p < 0.03). The following were significant predictors of shorter DFS: N-stage (p < 0.001); T-stage (p=0.001); loss of antigen A (p=0.01); mucin expression (p < 0.01); cough (p=0.02); Ki-67 expression (p=0.02) and negative bcl-2 expression (p=0.03). Analysis of survival difference for histologic subtype, degree of differentiation, aneuploidy, %S-phase, codon 12 K-ras mutation, and immunohistochemistry staining for Lewis^y, p53, Rb, microvessel count, HER2, E-cadherin and neuroendocrine markers did not reach statistical significance. In multivariate analysis, the following predicted for shorter overall survival: N-stage (p < 0.01), antigen A (p=0.01), age (p < 0.01), and bcl-2 (p = 0.05); and for DFS, N-stage (p < 0.01), antigen A (p < 0.01), Ki-67 (p = 0.03), mucin (p = 0.04) and T-stage (p = 0.05). Of all the clinical-pathological, proliferative, and biological markers studied, only a few carried independent prognostic significance.     

益骨汤对去卵巢大鼠骨密度骨钙素及成骨细胞增殖的影响

目的:观察补肾中药益骨汤对去卵巢大鼠成骨功能的影响。方法:取12周龄W istar雌性大鼠40只,随机分为A(模型组)、B(治疗组)、C(阳性对照组)、D(正常对照组)4组,每组10只,前3组行完整双侧卵巢摘除术,D组行假手术,术后常规饲养12周,再分别予以生理盐水、益骨汤水提液、α-D3水溶液及生理盐水灌胃治疗12周,处死大鼠,取血清用放免法测定血清中BGP水平;以双能X线密度仪测定大鼠右股骨上干骺端骨密度;取右胫骨上端做病理切片,通过HE染色对成骨细胞进行观察比较。结果:治疗组血清BGP、骨矿含量、骨密度明显高于模型组,HE染色发现其成骨细胞数量明显增加。结论:益骨汤能促进成骨细胞增殖,提高血清BGP水平,加快骨形成,具有治疗OP的作用。     

Construction and characterization of monoclonal antibodies against the extracellular domain of B-lymphocyte antigen CD20 using DNA immunization method

To date, several new anti-CD20 monoclonal antibodies (mAbs) have been developed for potential efficacies compared with familiar mAb rituximab. Despite the recent advances in development of anti-CD20 mAbs for the treatment of B cell malignancies, the efforts should be continued to develop novel antibodies with improved properties. However, the development of mAbs against CD20 as a multi-transmembrane protein is challenging due to the difficulty of providing a lipid environment that can maintain native epitopes. To overcome this limitation, we describe a simple and efficient DNA immunization strategy for the construction of a novel anti-CD20 mAb with improved anti-tumour properties. Using a DNA immunization strategy that includes intradermal (i.d.) immunization with naked plasmid DNA encoding the CD20 gene, we generated the hybridoma cell line D4, which secretes functional mAbs against an extracellular epitope of CD20. Immunocytochemistry analysis and a cell-based enzyme-linked immunosorbent assay using a Burkitt's lymphoma cell line showed that D4 mAbs are capable of binding to native extracellular epitopes of CD20. Moreover, the binding specificity of D4 mAbs was determined by western blot analysis. Cell proliferation was examined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptosis was detected by the annexin V/propidium iodide staining and dye exclusion assay. The results showed that D4 anti-CD20 mAbs produced by DNA immunization exhibit potent growth inhibitory activity and have superior direct B-cell cytotoxicity compared to rituximab. We propose that antibody-induced apoptosis is one of the mechanisms of cell growth inhibition. Taken together, the data reported here open the path to DNA-based immunization for generating pharmacologically active monoclonal antibodies against CD20. In addition, the data support future in vivo animal testing and subsequent procedures to produce a potential therapeutic mAb.