Clinical Evaluation of an Immunoradiometric Assay for CA15-3 Antigen Associated With Human Mammary Carcinomas: Comparison With Carcinoembryonic Antigen

Serum levels of CA15-3, a mammary tumor associated antigen recognizedby two different murine monoclonal antibodies (115D8 and DF3),were investigated in patients with mammary carcinoma and otherbenign or malignant diseases. The reference value of the serumCA15-3 level was obtained as 24 units/ml at the 99% confidencelimit among healthy individuals (n = 462). Elevation of serumCA15-3 levels was observed in 24.3% of overall patients withmammary carcinoma. Serum CA15-3 levels in breast cancer patientscorrelated with the clinical stage; higher percentages of positivitywere observed in those with advanced breast cancer (stage IV,64.7%, recurrent, 52.4% and metastatic, 70.3%). Furthermore,elevated serum CA15-3 levels in breast cancer patients respondedwell to the effect of therapy. Although the serum CA15-3 testgave percentages of positivity of breast cancer similar to thosefound by the serum CEA test, the serum CA15-3 test revealedlower percentages of posi-tivity than the serum CEA test amongpatients with benign breast lesions, liver cirrhosis or othercarcinomas. These results suggest that the serum CA15-3 antigenlevel provides a very useful marker for diagnosis and clinicalmonitoring of patients with breast cancer.     

Involvement of caspase-4 in IL-1 beta production and pyroptosis in human macrophages during dengue virus infection

Caspase-4 physically interacts with caspase-1 and is believed to be a proinflammatory caspase that can induce the inflammatory form of programmed cell death (pyroptosis) and the release of mature interleukin (IL)-1β. However, the function of caspase-4 in dengue virus infection is not yet fully understood. We examined the function of caspase-4 in IL-1β production and pyroptosis during dengue virus serotype-2 (DENV-2) infection in human macrophages. In this study, DENV-2 infection increased IL-1β protein level with activated caspase-4 activity. Using primary macrophages, we observed that caspase-4 induces activation of caspase-1 and secretion of IL-1β in response to DENV-2 infection, without the need for secondary signals to stimulate the assembly of the inflammasome. These findings indicate that the regulation of caspase-1 activity by capsase-4 could represent a unique mechanism. Our data suggest that caspase-4 is upstream of caspase-1 in the pathway that regulates pyroptosis and IL-1β synthesis in macrophages during DENV-2 infection.     

中国登革热的流行现状

登革热是由登革病毒4个血清型引起的急性传染病。广泛流行于全球热带和亚热带地区,是分布最广,发病最多,危害较大的一种虫媒病毒性疾病。本文就登革热在我国的流行历史、流行现状进行了回顾和总结,对该病流行的各个基本环节、预防控制、预警等方面的研究情况进行了综述,并对数据收集、分析和整理方面存在的问题提出了建议。     

乌苯美司联合DF方案治疗晚期食管癌的效果观察

目的:观察乌苯美司联合DF方案治疗晚期食管癌的临床疗效及不良反应。方法:将54例晚期食管癌患者随机分为对照组(30例)和观察组(24例),对照组采用DF方案化疗,观察组在DF方案基础上加用乌苯美司片。评价两组患者化疗效果及生活质量,观察不良反应。结果:观察组总有效率为45.8%,对照组为40.0%,差异无统计学意义(P>0.05)。观察组进展率为16.7%,对照组为43.3%,差异有统计学意义(P<0.05)。观察组生活质量评价优于对照组(P<0.05),血液系统不良反应发生率低于对照组(P<0.05)。结论:乌苯美司联合DF方案能改善晚期食管癌化疗效果及生活质量,并对化疗有一定的减毒作用。     

糖尿病足截肢平面确定及影响因素的研究进展

糖尿病足（DF）是目前非创伤性截肢的主要原因,且有呈逐年上升的趋势。目前有较多的检查手段用于帮助截肢平面的确定,选择一种或几种检查手段来帮助确定一个合适的平面进行截肢手术是临床医师必须要考虑的问题。该文对几种常用于帮助DF截肢平面确定的检查手段及一些影响因素进行综述。     

Hepatitis B virus wild‐type and rtN236T populations show similar early HBV DNA decline in adefovir refractory patients on a tenofovir‐based regimen

Summary. Hepatitis B virus (HBV) pol/RT mutations that confer clinical resistance to tenofovir disoproxil fumarate (TDF) have not been detected to date. In vitro, the rtN236T adefovir dipivoxil (ADV)‐associated resistance mutation confers low‐level cross‐resistance to tenofovir: 3‐ to 13‐fold changes in EC₅₀ from wild type. This study evaluated the clinical response of rtN236T mutant viruses by comparing their early viral load decay kinetics to wild‐type viruses in chronic HBV monoinfected patients harbouring rtN236T prior to initiating TDF or emtricitabine (FTC)/TDF therapy. Baseline samples (n = 105) from adefovir refractory patients were tested for the presence of rtN236T using a highly sensitive allele‐specific PCR assay with an rtN236T detection cut‐off of 0.5%. The rtN236T mutation was detected at baseline in 14.3% (14/98) of analysable patient samples (0.5–93.2%, rtN236T percentage range). The median change in total HBV DNA at week 24 was comparable for patients with rtN236T detected at baseline (?3.7 log₁₀ copies/mL, n = 14) as compared to patients with wild‐type HBV (?3.2 log₁₀ copies/mL, n = 90). In patients with rtN236T, wild‐type and rtN236T mutant virus showed similar rates of HBV DNA decline with no statistically significant difference observed at week 4. Moreover, the proportion of rtN236T remained unchanged in patients in either arm of the study during treatment. In conclusion, the rtN236T mutant virus showed similar HBV DNA decline kinetics to wild‐type virus in adefovir refractory patients who switched to TDF or FTC/TDF. Despite low levels of cross‐resistance in vitro, TDF similarly suppresses wild‐type and rtN236T mutant viruses in vivo.     

经皮氧分压测定在糖尿病足和周围动脉病变诊治中的应用

经皮氧分压（TcPO2）作为一种无创、相对精确的检查方法,以其直接反应微循环情况、预测糖尿病足（DF）下肢缺血情况、观察不同治疗方式的效果、确定截肢平面等优势在临床上应用越来越多,但因其为非侵入性检查方法,故在DF诊治上仍需进一步改善.     

Anovulatory effect of a LHRH antagonist in women

The antagonistic analog of LHRH, NAc-D-p-C1-Phe^1,2, D-Trp³, D-Phe⁶, D-Ala¹⁰-LHRH was administered intramuscularly in a dose of 2 mg to ten normally ovulating women on day 12 of the menstrual cycle. Ovulation was inhibited in six patients, and two more presented an insufficient corpus luteum. No pregnancies were recorded in this series. In those patients who did not ovulate, it was demonstrated that the LHRH analog abolished the midcycle surge of both LH and FSH. Luteolysis evidenced by the rapid decline in progesterone levels was present in 2 cases. Bleeding pattern showed a tendency to delayed menses. The morphological findings in endometrial biopsies of 6 women exhibited mild proliferation. Further research along these lines is necessary for appraisal of this approach to birth control.     

肠功能恢复汤与东菱克栓酶预防术后肠粘连的实验研究

目的：观察中药肠功能恢复汤与东菱克栓酶预防术后腹腔肠粘连的效果及对切口愈合的影响。方法：采用Ｗｉｓｔａｒ大鼠７２只，双盲随机分组法分为四组，制成肠粘连模型。分为中药治疗组，腹腔注入东菱克栓酶组，中药治疗加腹腔注入东菱克栓酶组，并分别与对照组比较。结果：中药肠功能恢复汤、东菱克栓酶：①能明显降低腹腔内渗液纤维蛋白原的浓度，能加速纤维蛋白（原）的分解，②能明显减轻肠粘连的程度，以二药合用效果最好（Ｐ＜０．０１）。③对腹腔内脏器的缝合口及腹壁切口的愈合无不良影响。结论：中药肠功能恢复汤与东菱克栓酶联合应用是预防腹腔术后肠粘连的简单有效药物及方法     

Bile acids induce ileal damage during experimental necrotizing enterocolitis

BACKGROUND & AIMS: Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency of premature infants. While the effect of bile acids (BAs) on intestinal mucosal injury is known, we investigated the contribution of BAs during the development of NEC in neonatal rats. METHODS: Premature rats were fed with cow's milk-based formula and subjected to asphyxia and cold stress to develop NEC. Jejunal and ileal luminal BAs, portal blood BAs, and messenger RNA and protein for the apical sodium-dependent bile acid transporter, the ileal bile acid binding protein, and the heteromeric organic solute transporter (Ostalpha/Ostbeta)were evaluated. RESULTS: Ileal luminal BAs levels were increased significantly during disease development and the removal of ileal BAs significantly decreased the incidence and severity of disease. Furthermore, when NEC was reduced via treatment with epidermal growth factor (EGF), BA levels were reduced significantly. Jejunal luminal BA levels were similar between animals with NEC and controls, but portal/ileal luminal BA ratios were decreased significantly in animals with NEC. The apical sodium-dependent bile acid transporter was up-regulated at the site of injury in animals with NEC and decreased after EGF treatment; however, the ileal bile acid binding protein was up-regulated only in the NEC and EGF group. Ostalpha/Ostbeta expression was low in all groups, and only slightly increased in the NEC group. CONCLUSIONS: These data strongly suggest that BAs play a role in the development of ileal damage in experimental NEC and that alterations in BA transport in the neonatal ileum may contribute to disease development.