Intracranial ependymomas: molecular insights and translation to treatment

Ependymomas are primary central nervous system tumors (CNS), arising within the posterior fossa and supratentorial regions of the brain, and in the spine. Over the last decade, research has resulted in substantial insights into the molecular characteristics of ependymomas, and significant advances have been made in the establishment of a molecular classification system. Ependymomas both within and between the three CNS regions in which they arise, have been shown to contain distinct genetic, epigenetic and cytogenic aberrations, with at least three molecularly distinct subgroups identified within each region. However, these advances in molecular characterization have yet to be translated into clinical practice, with the standard treatment for ependymoma patients largely unchanged. This review summarizes the advances made in the molecular characterization of intracranial ependymomas, outlines the progress made in establishing preclinical models and proposes strategies for moving toward subgroup‐specific preclinical investigations and treatment.     

15例ABO亚型的血型血清学分析

目的了解ABO亚型在怀化地区的分布情况。方法对正反定型不符及疑难配血的标本通过红细胞抗原、血浆抗体及唾液中血型物质检测以及红细胞吸收放散试验进行亚型鉴定。结果 15例可疑标本共检出A亚型4例,B亚型11例,亚型种类为A2、A3、Ael、B3、AB3和Bx。结论鉴定血型亚型对临床安全输血至关重要。     

Outcomes 1 year after thrombus aspiration for myocardial infarction

Routine intracoronary thrombus aspiration before primary percutaneous coronary intervention(PCI) in patients with ST-segment elevation myocardial infarction(STEMI) has not been proved to reduce short-term mortality.We evaluated clinical outcomes at 1 year after thrombus aspiration. Methods We randomly assigned 7244 patients with STEMI to undergo manual thrombus aspiration followed by PCI or to undergo PCI alone, in a registry-based, randomized clinical trial. The primary end point of all-cause mortality at 30 days has been reported previously. Death from any cause at 1 year was a prespecified secondary end point of the trial. Results No patients were lost to follow-up. Death from any cause occurred in 5.3% of the patients(191 of 3621 patients) in the thrombus-aspiration group, as compared with 5.6%(202 of 3623) in the PCI-only group(hazard ratio, 0.94; 95% confidence interval [CI], 0.78 to 1.15; P = 0.57). Rehospitalization for myocardial infarction at 1 year occurred in 2.7% and 2.7% of the patients, respectively(hazard ratio, 0.97; 95% CI, 0.73 to1.28; P = 0.81), and stent thrombosis in 0.7% and 0.9%, respectively(hazard ratio, 0.84; 95% CI, 0.50 to1.40; P = 0.51). The composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis occurred in 8.0% and 8.5% of the patients, respectively(hazard ratio, 0.94; 95% CI, 0.80 to1.11; P = 0.48). The results were consistent across all the major subgroups, including grade of thrombus burden and coronary flow before PCI. Conclusions Routine thrombus aspiration before PCI in patients with STEMI did not reduce the rate of death from any cause or the composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis at 1 year.     

Outcomes 1 year after thrombus aspiration for myocardial infarction

Background Routine intracoronary thrombus aspiration before primary percutaneous coronary intervention(PCI) in patients with ST-segment elevation myocardial infarction(STEMI) has not been proved to reduce short-term mortality. We evaluated clinical outcomes at 1 year after thrombus aspiration.Methods We randomly assigned 7244 patients with STEMI to undergo manual thrombus aspiration followed by PCI or to undergo PCI alone, in a registry-based, randomized clinical trial. The primary end point of all-cause mortality at 30 days has been reported previously. Death from any cause at 1 year was a prespecified secondary end point of the trial.Results No patients were lost to follow-up. Death from any cause occurred in 5.3% of the patients(191 of 3621 patients) in the thrombus-aspiration group, as compared with 5.6%(202 of 3623) in the PCI-only group(hazard ratio, 0.94; 95% confidence interval [CI], 0.78 to 1.15; P = 0.57). Rehospitalization for myocardial infarction at 1 year occurred in 2.7% and 2.7% of the patients, respectively(hazard ratio, 0.97; 95% CI, 0.73 to1.28; P = 0.81), and stent thrombosis in 0.7% and 0.9%, respectively(hazard ratio, 0.84; 95% CI, 0.50 to1.40; P = 0.51). The composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis occurred in 8.0% and 8.5% of the patients, respectively(hazard ratio, 0.94; 95% CI, 0.80 to1.11; P = 0.48). The results were consistent across all the major subgroups, including grade of thrombus burden and coronary flow before PCI.Conclusion Routine thrombus aspiration before PCI in patients with STEMI did not reduce the rate of death from any cause or the composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis at 1 year.(From: N Engl J Med 2014; 371:1111-1120 September 18, 2014DOI: 10.1056 / NEJMoa1405707)     

宫颈癌患者肿瘤坏死因子、T淋巴细胞亚群检测及其临床意义

采用抗CD3^ 、CD4^ 、CD才单克隆抗体致敏的羊红细胞花环形成法及肿瘤坏死因子(Tumor Necrogenic Factor,TNF)检测药盒，检测了42例宫颈癌患的外周血T淋巴细胞亚群和血浆TNF水平及外周血单个核细胞(PBMC)经LPS诱导产生TNF的能力。结果表明：1．宫颈癌患CD3^ 、CD4^ 、CD8^ 的百分率及CD4／CD8的比值较正常人明显降低(P<0．01)，治疗后有明显提高。2．宫颈癌患血浆中由于受到肿癌抗原的不断刺激,TNF水平较高，与正常人比较有显意义(P<0．01)．但治疗后明显下降(P<0．01)。血浆中TNF的水平与外周血单个核细胞产生TNF的能力不一致。     

感染旋毛虫大鼠T淋巴细胞亚群的动态观察

[目的]观察感染旋毛虫大鼠T淋巴细胞亚群的动态变化。[方法]采用免疫组化的方法分别检测感染旋毛虫后7、14、21、28、35、60 d大鼠外周血CD3 、CD4 、CD8 T淋巴细胞的百分率。[结果]在6个时相, 实验组大鼠感染旋毛虫后CD3 T细胞数量虽均低于对照组,但仍在正常范围内,其差异无统计学意义(P> 0．05),CD4 T细胞减少,CD8 T细胞增多,CD4 ／CD8 细胞比值下降(P<0．05),以感染后第14天最明显, 直到感染后60 d仍未见恢复。[结论]感染旋毛虫的大鼠出现免疫抑制现象,感染急性期的免疫抑制程度最高, 感染大鼠的免疫抑制主要发生在成虫产新生蚴及新生蚴移行期。     

Comorbidity and subgroups in childhood autism

The objective of this study was to identify clinical subgroups in children with childhood autism and to examine comorbidity in each subgroup. The study was based on medical records of 30 inpatients referred to a specialist ward for children with pervasive developmental disorders. Eighteen consecutive patients with an IQ above 50 and fulfilling research criteria for childhood autism were grouped in accordance with the Wing's social subgroups of autism (aloof, passive, and active but odd). Comorbidity, in terms of deficits in attention, motor control, visuo-motor and visuo-spatial function, as well as epilepsy, was described in each of the three groups. The aloof and passive groups produced a pure autistic triad of deficits, while the active but odd group was characterized by strong comorbidity. Accepted: 14 May 1999     

不同中医证型肝硬化患者T细胞亚群NK细胞及补体系统检测的意义

目的:探讨不同中医证型肝硬化与血T细胞亚群、NK细胞、补体系统的关系。方法:对92例肝硬化患者进行中医分型,分为气滞湿阻型、肝脾血瘀型、脾肾阳虚型,并进行了外周血T细胞亚群、NK细胞以及补体C3、C4、B因子的测定;并设立正常对照组。结果:不同中医证型肝硬化的血CD3 、CD4 、CD4 /CD8 、NK细胞均有不同程度的降低,CD8 无明显变化;补体C3、C4、B因子均有不同程度的降低。结论:肝硬化的血T细胞亚群、NK细胞、补体系统存在着不同程度的变化,并与中医证型相关。     

Subject-by-Formulation Interaction in Bioequivalence: Conceptual and Statistical Issues

Purpose. The FDA has proposed replacing the current averagebioequivalence criterion with population and individual bioequivalence criteriathat consider variances in addition to the difference of averages. Oneof these variances in the individual bioequivalence criterion measuressubject-by-formulation interaction, the extent to which thetest-reference difference varies from person to person. This paper discussesconceptual and statistical issues raised in various publications andpresentations with respect to the presence and estimation of such aninteraction. Methods. We focus on the importance of subject-by-formulationinteraction, an understanding of what is a large interaction, and theassessment of the magnitude of this interaction in bioequivalence studies.Simulation studies, examples from the literature, and data from FDAfiles are used to demonstrate the magnitude of the interaction and itsdistribution under various conditions. Results. The concept of a large interaction is tied to the concept of alarge mean difference. We suggest that an interaction greater than0.15 is a conservative criterion for a large interaction. Magnitudes ofestimated interaction are affected by variability, sample size, and theselection of data sets that pass average bioequivalence. Conclusions. Examples of substantial interactions are beginning toappear. More data is needed before reaching definitive conclusionsregarding the frequency and importance of observed interactions.     

Novel glycolipid variations revealed by monoclonal antibody immunochemical analysis of weak ABO subgroups of A

BACKGROUND AND OBJECTIVES: The chemical basis of the subgroups of A is largely unknown. We used thin-layer chromatography immunochemical staining techniques together with a range of characterized monoclonal reagents to analyse glycolipids isolated from a variety of weak subgroups. MATERIALS AND METHODS: Glycolipids isolated from red cells collected from nine genetically defined individuals of the rare subgroups of A, including a novel A(3) allele (A(2) 539G>A) not described previously, were subjected to a highly sensitive thin-layer chromatographic immunochemical analysis. RESULTS: Semicharacterized monoclonal antibodies revealed that, in addition to the expected quantitative differences between common phenotypes and the weak subgroups, qualitative glycolipid differences (or at least an apparent qualitative basis), caused by major changes in the ratios of different structures exist. Specifically it was found that the weakest A-expressing samples (A(el) phenotype) appeared to express an unusual A structure in the 8-12 sugar region. Variable expression of several structures in one of the A weak samples were suggestive of novel blood group A structures. CONCLUSIONS: Although no structural characterization could be undertaken, the results are clearly indicative that the variant glycosyltransferases of the rare ABO subgroups are not only inefficient, but they may potentially synthesize novel ABO structures.