~（18）F-FDG SPECT/CT检查结合CA125检测在卵巢癌术后复发转移诊断中的价值

目的：探讨18F-FDG SPECT/CT检查结合CA125检测在卵巢癌术后复发病例的早期诊断价值。方法：对43例卵巢癌术后病例同时进行18F-FDG SPECT/CT检查和CA125检测,怀疑复发的病例进行CT/MRI检查和临床随访,以进一步确诊。结果：43例病人中,18F-FDG SPECT/CT检查发现核素异常浓聚24例,经CT/MRI检查和临床资料证实为转移灶19例,阳性率和假阳性率分别为44.2%、11.6%,特异性为83.8%。本组病例CA125升高13例,证实为转移灶病例中CA125升高12例,阳性率和假阳性率分别为27.9%、2.3%,特异性为96.9%。结论：18F-FDG SPECT/CT检查和CA125检测是卵巢癌术后复发的可靠检查方法。     

Phase I and pharmacologic study of the human DNA methyltransferase antisense oligodeoxynucleotide MG98 given as a 21-day continuous infusion every 4 weeks

Purpose: MG98 is a second generation phosphorothioate antisense oligodeoxynucleotide which is a highly specific inhibitor of translation of the mRNA for human DNA MeTase I (DNMT 1). This phase I study examined the toxicity and pharmacologic profile of MG98 administered as a continuous 21-day intravenous infusion every 4 weeks. Patients and methods: Fourteen patients with solid cancers received a total of 25 cycles of MG98 at doses ranging from 40 to 240 mg/m²/day. Steady-state concentrations of MG98 were measured as were several pharmacodynamic assessments including mRNA of the target gene, DNMT1, in PBMC. In addition, other potential surrogate markers of drug effects were explored, including hemoglobin F, Vimentin and GADD45. Results: Dose limiting effects were drug-related reversible transaminase elevation and fatigue seen at doses of 240, 200 and 160 mg/m²/day. The dose level of 80 mg/m²/day was felt to be safe and tolerable when delivered on this schedule. No evidence of antitumor activity was observed. Although pharmacokinetic analysis revealed that at the higher dose levels, mean Css values of MG98 were approximately 10-fold times the IC₅₀ values associated with target inhibition in vitro, the extent of MG98 penetration into target tumors in this trial was not determined. No consistent, dose-related changes in correlative markers including DNMT1 mRNA, hemoglobin F, Vimentin and GADD45, were observed. Conclusions: This schedule of MG98 given as a 21-day continuous intravenous infusion every 4 weeks was poorly tolerated in the highest doses; therefore, further disease-site specific evaluation of the efficacy of this agent will utilize a more favorable, intermittent dosing schedule. Pharmacodynamic evaluations undertaken in an attempt to explore and validate the biological mechanisms of MG98 did not show dose-related effects.     

IFN‐α/β‐mediated NK2R expression is related to the malignancy of colon cancer cells

Neurokinin 2 receptor (NK2R), a G protein‐coupled receptor for neurokinin A (NKA), a tachykinin family member, regulates various physiological functions including pain response, relaxation of smooth muscle, dilation of blood vessels, and vascular permeability. However, the precise role and regulation of NK2R expression in cancer cells have not been fully elucidated. In this study, we found that high NK2R gene expression was correlated with the poor survival of colorectal cancer patients, and Interferon (IFN‐α/β) stimulation significantly enhanced NK2R gene expression level of colon cancer cells in a Janus kinas 1/2 (JAK 1/2)‐dependent manner. NKA stimulation augmented viability/proliferation and phosphorylation of Extracellular‐signal‐regulated kinase 1/2 (ERK1/2) levels of IFN‐α/β‐treated colon cancer cells and NK2R blockade by using a selective antagonist reduced the proliferation in vitro. Administration of an NK2R antagonist alone or combined with polyinosinic‐polycytidylic acid, a synthetic analog of double‐stranded RNA, to CT26‐bearing mice significantly suppressed tumorigenesis. NK2R‐overexpressing CT26 cells showed enhanced tumorigenesis and metastatic colonization in both lung and liver after the inoculation into mice. These findings indicate that IFN‐α/β‐mediated NK2R expression is related to the malignancy of colon cancer cells, suggesting that NK2R blockade may be a promising strategy for colon cancers.     

Troponina I por Percentil 99 da Definição Universal de Infarto do Miocárdio versus Ponto de Corte de Melhor Acurácia em Síndromes Coronárias Agudas

Background Contemporary diagnosis of ACS and risk stratification are essential for appropriate management and reduction of mortality and recurrent ischemic events, in the acute phase of disease and after hospitalization. The Universal Definition of Myocardial Infarction recommends the detection of troponin levels above the 99^th percentile.Objectives To evaluate the occurrence of early death and acute myocardial infarction (AMI) in patients without elevation of troponin (<0.034 ng/mL), patients with mild elevation (above the 99^th percentile [>0.034 ng/mL and <0.12 ng/mL)], and patients with significant elevation of troponin (above the diagnostic cutoff for AMI defined by the troponin kit (≥0.12 ng/mL)]; and to analyze the impact of troponin on the indication for invasive strategy and myocardial revascularization.Methods Cross-sectional cohort study of patients with ACS with assessment of peak troponin I, risk score, prospective analysis of 30-day clinical outcomes and two-sided statistical tests, with statistical significance set at p<0.05.Results A total of 494 patients with ACS were evaluated. Troponin > 99^th percentile and below the cutoff point, as well as values above the cutoff, were associated with higher incidence of composite endpoint (p<0.01) and higher rates of percutaneous or surgical revascularization procedures (p<0.01), without significative difference in 30-day mortality.Conclusions Troponin levels above the 99^th percentile defined by the universal definition of AMI play a prognostic role and add useful information to the clinical diagnosis and risk scores by identifying those patients who would most benefit from invasive risk stratification and coronary revascularization procedures.     

放射性125I粒子对泪腺腺样囊性癌组织杀伤作用的观察

背景腺样囊性癌（ACC）是泪腺上皮性肿瘤中恶性程度最高的一种肿瘤,侵袭性强,复发率和死亡率高。尽管可以采用手术切除、放射治疗和化学治疗等综合性治疗,但疗效仍欠佳。目的探讨125I粒子组织间植入对裸鼠移植性ACC的治疗效果,以及粒子放射活度与疗效的关系。方法在BALB／C裸鼠背部皮下注射0．1ml ACC-2癌细胞5×10^7个／ml建立荷人ACC裸鼠模型30只。注射后14d选取瘤体体积大致相等的荷瘤鼠25只,用随机数字表法分为5组,每组5只裸鼠。治疗组每只裸鼠分别植入1枚125I粒子,按放射活度分为G1组（0．4mCi）、G2组（0．6mCi）、G3组（0．8mCi）、G4组（1．0mCi）4个治疗组,G0组（对照组）植入无活性的空心粒子1枚,B型超声扇形扫描对125I粒子进行定位监测。每2天测量1次肿瘤直径并计算各组肿瘤体积抑制率,14d后断颈处死裸鼠,制作肿瘤组织标本,行透射电子显微镜及常规病理学染色检测肿瘤坏死凋亡情况并记录肿瘤坏死凋亡边缘距离125I粒子的最大半径。结果125I粒子植入14d,G0组平均瘤体积为（3713．19±243．23）mm3,G1组、G2组、G3组、G4组分别为（3113．35±316．54）、（2635．85±261．21）、（2538．37±312．16）、（1686．28±231．65）mm3,与G0组比较,差异均有统计学意义（P〈0．05）;G1组、G2组、G3组、G4组的抑瘤率分别为（20．11±3．09）％、（36．18±2．54）％、（40．83±4．17）％、（66．63±5．34）％,即随着125I放射活度的增加,抑瘤率明显增高,差异有统计学意义（F=120．240,P=0．000）。125I放射活度与抑瘤率呈正相关（r=0．653,P=0．008）。G1组、G2组、G3组、G4组凋亡或坏死距离粒子的最大有效治疗半径依次为（5．2±0．5）、（6．4±0．7）、（7．4±0．4）、（8．2±0．5）rnm,差异有统计学意义（F=29．22,P=0．000）;125I放射活度与最大有效治疗半径呈正相关（r=0．609,P=0．004）。结论125I粒子组织间植入对裸鼠移植性ACC持续照射可以抑制肿瘤细胞增生周期,是一种安全、有效、可行、不良反应少的治疗方法。     

Ⅰ型糖尿病患者清晨高血糖原因分析及处理

目的:提高对糖尿病患者清晨高血糖的诊治.方法:对16例空腹血糖大于10mmoL/L的Ⅰ型糖尿病患者,进行0时至8时每小时从静脉保留导管采血,共9次,测血糖.结果:3例诊断为Somogyi现象(低血糖后高血糖),7例为黎明现象,6例为胰岛素用量不足.结论:Ⅰ型糖尿病病人治疗过程中出现高血糖常见原因有胰岛素用量不足,黎明现象和Somogyi现象,三者处理各异,应测午夜点血糖鉴别,给予合理的处理.     

水红花子与商陆种子的比较研究

目的:对近期出现的水红花子与掺伪品商陆种子进行鉴别研究。方法:在植物分类和调查的基础上,对二者在性状、显微、薄层方面进行了比较研究。结果:水红花子与商陆种子在性状、显微、薄层色谱方面有明显的区别。结论:水红花子与商陆种子可以通过性状、显微、薄层色谱等方面进行鉴别。     

Serum insulin‐like growth factor‐I concentrations in late middle age: no association with birthweight in three UK cohorts

Background: Small body size at birth and during infancy is associated with an increased risk of adult osteoporosis and cardiovascular disease. Fetal programming of the growth hormone–insulin‐like growth factor (GH‐IGF) axis may provide a mechanism for these epidemiological findings. Aims: To determine whether measurements of GH and IGF‐I in late middle age were related to size at birth and in infancy. Methods: Overnight urinary GH excretion and fasting serum IGF‐I were measured in 309 men and 193 women from Hertfordshire (born 1920–1930) for whom birthweight and weight at 1 year were recorded. Serum IGF‐I was measured in men and women from Preston (n = 254, born 1935–1943) and Sheffield (n = 215, born 1939–1940) whose birthweight and other birth measurements were recorded. Results: Urinary GH and serum IGF‐I were not related to birthweight, other measurements at birth, or weight at 1 year. Conclusion: In contrast to previous studies in children or young adults, these data do not support the hypothesis that IGF‐I concentrations are programmed by intra‐uterine events, as assessed by birthweight, in late middle age.