荧光定量PCR与PP65抗原检测在诊断儿童巨细胞病毒活动性感染的比较

目的用实时荧光定量聚合酶链反应(FQ-PCR)和pp65抗原检测儿童人巨细胞病毒(HCMV)感染,并对其诊断HCMV活动性感染进行比较评估。方法分析924例HCMV血清学检测阳性的儿童的全血HCMV-DNA荧光定量PCR及HCMV-pp65抗原检测结果,与临床诊断的符合程度进行比较。结果全血HCMV-DNA荧光定量PCR和pp65抗原检测的一致率为81.17%,其标准误为0.39,Kappa值为0.60;PCR检测HCMV感染的灵敏度为98.4%,特异度为97.3%,Youden指数为0.957,PVP和PVN分别为0.961和0.989;pp65抗原检测用于检测HC-MV感染的灵敏度为59.2%,特异度为100%,Youden指数为0.592,PVP和PVN分别为1.00和0.782。结论全血HCMV-DNA荧光定量PCR和pp65抗原检测的结果有较好的一致性,诊断HCMV感染PCR检测的灵敏度较pp65抗原检测的灵敏度要高,而后者的特异度较前者高。二种方法都可用于CMV活动性感染的诊断。     

NF-kB表达与胃癌的相关性研究

目的探讨NFkB在胃癌发生过程中的作用以及NFkB p^65与胃癌临床病理学参数之间的关系。方法采用免疫组织化学En Vision二步法，检测52例胃癌与癌旁组织，20例胃肠化粘膜及20例正常胃粘膜中的NFkB p^65亚单位蛋白的阳性表达情况。结果在胃癌、胃肠化组织、癌旁组织和正常胃粘膜中，NFkB p^65阳性表达率分别为59.71％，40％，17．31％，0（P〈0.01）。在胃癌、胃肠化组织、癌旁组织中的NFkB p^65表达与正常胃粘膜相比存在显著性差异（P〈0．05）。在低级别分化胃癌组中，NFkB p^65表达明显高于高级别分化组（P〈0．05）。结论NFkB p^65是胃癌相关的一种蛋白，其阳性表达与胃癌细胞的分化程度呈负相关。NFkB p^65的检测可作为对胃癌癌前病变、胃癌转移的一项判断指标。     

Use of the cytomegalovirus pp65 antigenemia assay for preemptive therapy in allogeneic hematopoietic stem cell transplantation: a real‐world review

Abstract: Despite advances in surveillance strategies and antivirals, cytomegalovirus (CMV) infection continues to pose problems to patients receiving hematopoietic stem cell transplants (HSCTs). The bone marrow transplant (BMT) unit at the Singapore General Hospital embraced the preemptive strategy in late 2003. Although several studies have demonstrated its usefulness, we conducted this review to document CMV‐related events at our institution. Forty‐six patients underwent CMV surveillance using the CMV pp65 antigenemia (CMV Ag) assay from January 2004 to December 2005. Twenty‐seven patients had CMV infection, and 19 remained antigenemia‐negative. No differences were found between the 2 groups for the following potential risk factors for CMV infection: age, total number of co‐morbidities, duration of neutropenia after conditioning, baseline creatinine, type of conditioning regimen (conventional vs. reduced intensity), type of transplant (matched sibling vs. others), recipient CMV status, donor CMV status, and use of total body irradiation. Two patients received alemtuzumab; both developed CMV Ag. Twelve episodes of CMV infection occurred after the 100th post‐HSCT day. Two patients developed CMV disease. One of them could be considered a failure of the preemptive strategy, as she had CMV gastritis diagnosed on the same day that she became pp65‐positive. The other developed CMV disease despite prompt institution of ganciclovir, although she had multiple post‐HSCT complications requiring enhanced immunosuppression, as well as relapsed disease. One‐year disease‐free survival was 55.5% in those with CMV infection and 52.3% in those without infection. Survival was not affected by CMV infection.     

Hereditary hemochromatosis gene (HFE) mutations C282Y, H63D and S65C in patients with idiopathic dilated cardiomyopathy

BACKGROUND: Hereditary hemochromatosis (HH), a common autosomal recessive disease, leads to excessive iron accumulation in some organs, including the heart. It is therefore not surprising that cardiomyopathy is one of the most severe complications of HH. The HFE gene defects have been thought to contribute to idiopathic dilated cardiomyopathy (IDCM) in some patients, even though the results of genotype analyses have so far been contradictory. Hence we set out here to evaluate the prevalence and potential role of HFE mutations in patients with IDCM. METHODS: A total of 91 IDCM patients and 102 controls were subjected to HFE mutation analyses, in which C282Y, H63D and S65C mutations were determined for each patient. We also analyzed the impact of the C282Y and H63D mutations on the left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) functional classes. RESULTS: The prevalences of heterozygosity for the C282Y, H63D and S65C mutations in the IDCM patients were 13.2%, 22.0% and 2.2%, respectively. LVEDD was significantly higher (P=0.037) in those with the C282Y mutation at the end of the follow-up period than in those with no mutation. CONCLUSIONS: Our data showed no significant deviations in C282Y, H63D and S65C mutation frequencies between the IDCM patients and controls, suggesting that these mutations do not increase the risk of IDCM. Heterozygosity for the C282Y mutation may nevertheless be a modifying factor contributing to LV dilatation and remodeling.     

胃腺癌组织中生存素、核因子和p53基因表达的相关性研究

目的研究凋亡抑制基因生存素、核因子-kB p65和p53基因在胃腺癌组织中的表达情况，并探讨它们与胃腺癌生物学行为之间的关系。方法采用免疫组化S—P法，检测45例胃腺癌组织中生存素、核因子-kB p65及p53基因的表达情况。结果生存素、NF-kB p65和p53基因在胃腺癌组织和正常胃黏膜组织中表达水平差异具有统计学意义（P〈0．01）；生存素的表达情况与胃腺癌浸润深度、淋巴结转移及临床分期密切相关（P〈0．05），而与组织分化程度无关（P〉0．05）；NF-kB p65及p53与胃腺癌的浸润深度、淋巴结转移、临床分期及胃腺癌分化程度密切相关（P〈0．05）。结论胃腺癌组织中生存素、核因子-kB p65及p53基因在胃腺癌的各个阶段均有不同程度的表达，检测三者有助于胃腺癌恶性程度的判定及侵袭转移能力的评估。     

Diabetes mellitus among young adults in Sri Lanka—role of GAD antibodies in classification and treatment: The Sri Lanka Young Diabetes study

AIMS/HYPOTHESIS: Diabetes mellitus is increasing among young adult South Asians. The aim of this study was to determine the prevalence and phenotypic characteristics of diabetes subtypes based on GAD65 autoantibody (GADA) status in those with young adult-onset diabetes in Sri Lanka. METHODS: Clinical, metabolic and GADA data were available for 992 consecutively recruited individuals with diabetes aged < or =45 years (age at diagnosis 16-40 years). Participants were classified according to the following definitions: type 1 diabetes, insulin-dependent <6 months from diagnosis; latent autoimmune diabetes in adults (LADA), GADA-positive, age > or =30 years and insulin-independent > or =6 months from diagnosis; type 2 diabetes, GADA-negative and insulin-independent > or =6 months from diagnosis. RESULTS: The median (interquartile range) age at diagnosis and diabetes duration were 33.0 (29.0-36.1) and 4.0 (1.1-7.1) years, respectively; 42.1% were male. GADA positivity was seen in 5.4% of participants (n = 54) and GADA levels negatively correlated with age at diagnosis (p < 0.0001), BMI (p < 0.0001) and time to insulin requirement (p = 0.006). Type 1 diabetes, type 2 diabetes and LADA were present in 7.0%, 89.7% and 2.6%, respectively. The remaining 0.7% of the participants were GADA-positive, insulin independent > or =6 months from diagnosis and were diagnosed at age <30 years. The metabolic syndrome and homeostasis model assessment of beta cell function (HOMA %B) were lowest in GADA-positive type 1 diabetes and increased progressively in latent autoimmune diabetes, GADA-negative type 1 diabetes and type 2 diabetes. Among those requiring insulin, 69.2% had fasting C-peptide levels in the lowest quartile, whereas only 19.5% were GADA-positive (p < 0.0001). CONCLUSIONS/INTERPRETATION: The prevalence of GADA-positive autoimmune diabetes is low among individuals with young adult-onset diabetes in Sri Lanka. Young-onset diabetic phenotypes appear as a continuum from autoimmune type 1 diabetes to type 2 diabetes.     

膀胱移行细胞癌组织中NF-κB p65、uPA、Bcl-2的表达变化及其意义

目的观察膀胱移行细胞癌（下称膀胱癌）组织中NF—κBp65和尿激酶型纤溶酶原激活物（uPA）及Bcl-2的表达变化,并探讨其相关性。方法采用免疫组化SP法对40例膀胱癌组织和10例正常膀胱组织中NF—κBp65、uPA、Bcl-2进行测定,分析三者与膀胱癌分级、分期、侵袭转移及复发的关系及NF-κBp65表达与uPA、Bcl-2的相关性。结果NF-κBp65、uPA、Bcl-2在膀胱癌组织中的表达均明显高于正常膀胱组织（P〈0．05）;NF—κBp65和uPA与膀胱癌病理分级、分期、淋巴结转移有关（P均〈0．05）,Bcl-2与膀胱癌病理分级、分期有关（P〈0．05）,与淋巴结转移无关（P〉0．05）;膀胱癌组织中,NF—κBp65表达与uPA、Bcl-2表达呈正相关（r分别为0．388、0．462,P均〈0．05）。结论在膀胱癌组织中NF-κBp65、uPA、Bcl-2均呈高表达,并与膀胱癌的临床病理学特征有关;NF—κBp65可能通过调控uPA、Bcl-2的表达促进膀胱癌的进展;NF—κBp65、uPA、Bcl-2可以作为判断膀胱癌侵袭性、转移及预后的生物学标志物。     

CTP-MELD评分联合血清M30和M65预测乙型肝炎相关慢加急性肝衰竭短期预后的价值

目的探讨肝功能评分(CTP)-终末期肝病模型(MELD)联合血清M30和M65对乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)患者短期预后的预测价值。方法选择2017年1月至2020年1月南京市第二医院接受治疗的HBV-ACLF患者106例,根据90 d预后分为生存组51例与死亡组55例。比较两组患者一般情况、实验室指标、血清M30和M65水平,受试者特征曲线分析下面积CTP-MELD评分联合血清M30和M65与HBV-ACLF短期预后的关系。结果死亡组患者的CTP、MELD评分分别为(23.02±5.18)分和(31.18±5.89)分,高于存活组的(10.49±1.05)分和(13.21±1.34)分(t=16.949、21.276,均P<0.01);死亡组的血清M30、M65水平分别为(1685.12±413.32)U/L和(2799.41±712.05)U/L,均高于存活组的(1001.40±316.49)U/L和(1808.85±669.43)U/L(t=9.507、8.608,均P<0.01)。CTP、MELD、M30、M65单独预测90 d病死的AUC分别为0.624(95%CI:0.525~0.716)、0.804(95%CI:0.716~0.875)、0.750(95%CI:0.656~0.829)、0.887(95%CI:0.810~0.940),4项联合的AUC为0.919(95%CI:0.850~0.963),明显优于CTP、MELD、M30单项评价(P<0.05),高于M65单项评价但差异无统计学意义(P>0.05)。结论CTP、MELD评分和血清M30、M65能够较好地预测HBV-ACLF患者短期预后,且4项联合检测具有更高的预测价值。     

Bex1和NF-kBp65在舌鳞状细胞癌组织中的表达及意义

目的 探讨Bex1和NF-kBp65在舌鳞状细胞癌组织中的表达及意义.方法 免疫组化法检测60例舌鳞状细胞癌组织及相应癌旁正常组织中Bex1和NF-kBp65的表达情况,分析其与患者临床病理特征及预后的关系.结果 舌鳞状细胞癌组织中Bex1阳性表达率为48.3％(29/60),低于癌旁正常组织的88.3％(53/60)...