Hunting for robust gene signature from cancer profiling data: Sources of variability,different interpretations,and recent methodological developments

Gene microarray is a powerful platform to investigate the expression patterns of thousands of genes simultaneously. One central objective of such analysis is to select sets of genes (i.e., gene signatures) which correlate with clinical characteristics, such as disease subtype diagnosis, response to drug treatment and prognosis. However, previous studies have found that mRNA signatures are highly unstable and strongly depend on the selection of patient samples. Based on five large microRNA profiling datasets, we empirically found that microRNA signatures are also generally unstable. Therefore, concerns arise regarding the reproducibility and clinical applicability of these derived gene signatures. Here, we first provide a brief review on the sources of variability and different interpretations of multiple distinct gene signatures. We then focus on those recent methodological progresses aimed at developing more stable gene signatures.     

Developments in surgical revascularization to achieve improved morbidity and mortality

Coronary artery bypass graft surgery remains the main treatment modality for multivessel coronary artery disease and has consistently been demonstrated to have significantly lower rates of major adverse cardiac and cerebrovascular events in comparison to percutaneous coronary intervention. In this article we will explore the advances over time and the recent refinements in the techniques of surgical revascularization and how these contribute to the superior outcome profile associated with coronary artery bypass graft surgery. These include the current outcome status of coronary artery bypass grafting; the major landmark trials, registries and meta-analyses comparing coronary artery bypass grafting and percutaneous coronary intervention; the developments in coronary artery disease lesion classification; the techniques for the physiological assessment of coronary artery lesions; bypass grafting using arterial conduits; the role of off-pump coronary artery surgery; the outcomes of reoperative surgery; hybrid techniques for coronary revascularization; minimally invasive coronary artery surgery and finally robotic surgery.     

百草枯中毒的研究进展

随着百草枯(PQ)的广泛应用,PQ中毒事件数量逐年增加,已成为我国第二位的农药中毒事件。PQ对人有剧毒,中毒后致多脏器严重损害,病死率极高,其中毒机制尚不完全明确,氧自由基产生学说为大多数学者认可。PQ中毒暂无特效解毒药,临床上主要采取综合治疗的办法,如洗胃、导泻、吸附体内毒素、应用激素及免疫抑制剂、清除氧自由基、保护各脏器功能等,同时结合有效的血液净化手段,本文旨在对相关进展做一简要综述。     

An analysis of discourses shaping mental health practitioners

A mental health practitioner (MHP) role was introduced to health services in southern England in 2003. The paper will discuss the initial phase within a longitudinal research study. A discursive approach will be adopted in order to understand how healthcare discourses constrain and provide possibilities for the emergence of a new worker role in mental health. The manner in which MHPs understand and talk about their work is socially constructed in interaction and constantly being modified by competing discourses. This paper will analyse three overarching health discourses, namely, the biomedical, person-centred and psychological discourses that have shaped MHP trainees. Discourses intersect to inform the role, where practices of nursing, psychology, medicine and occupational therapy are combined. Thus, the inclusion of physical, psychological and person-centred components of care serve as a multifaceted approach to care. This form of interprofessionalism leads MHPs one step closer in the advance towards an interdisciplinary discourse of holistic care.     

AML患者外周血中TCR Vβ亚家族naive T细胞的检测

目的 检测急性髓性白血病(AML)患者外周血中TCR 23个Vβ亚家族的T细胞受体删除DNA环(sjTRECs)的存在特点,从而间接了解AML患者相应Vβ亚家族naive T细胞的近期胸腺输出情况.方法利用半巢式PCR分别扩增32例AML患者每5×104和1×104个外周血单个核细胞(PBMCs)中的23个Vβ亚家族sjTRECs,10例正常人外周血作为对照.结果在5×104和1×104两种PBMCs水平,AML患者检出sjTRECs的Vβ亚家族数分别为(5.09±3.28)和(2.59±2.06)个,与正常人的(13.70±2.67)和(5.50±2.07)个相比,两组的差异均有统计学意义(两组均为P=0.000).AML患者5×104个PBMCs中约可检测到5/23(20%)个Vβ亚家族sjTRECs,并且有13个Vβ亚家族sjTRECs的检出率明显低于正常人水平,其中Vβ10-和Vβ14-Dβ1 sjTRECs的检出率最低,而Vβ21最高.不同FAB分型AML患者间的检出差别未显示出统计学意义.32例AML患者检出sjTRECs的Vβ亚家族数量差别较大(1～15个),年龄与检出的亚家族数量呈负相关,＜30岁者的检出量高于≥30岁者,尤其在5×104个PBMCs水平差异有统计学意义(r=-0.481,P=0.005).结论 AML患者胸腺近期输出的23个Vβ亚家族naive T细胞存在不同程度的缺失或水平降低,表明AML患者存在严重的细胞免疫功能缺陷以及T细胞谱系重建的能力和潜能严重受损.     

Assessment of patient's pain-related behavior at physical examination may allow diagnosis of recent osteoporotic vertebral fracture

Background contextAlthough innumerable studies have analyzed the multiple aspects of osteoporotic vertebral fractures, no study has focused on the clinical features related to spine pain in patients with recent osteoporotic vertebral compression fractures (VCFs).PurposeTo determine whether the assessment of pain-related behavior (P-RB) of patients with osteoporotic VCFs of recent onset may allow the fracture to be strongly suspected, or even diagnosed, at physical examination.Study designPain-related behavior of elderly patients attending an outpatient spine clinic was evaluated on the basis of six consecutive movements made on the examining table.Patient sampleFifty-six patients complaining only of lumbar or thoracic pain. The fractured patients (FPs), representing the fracture group (FG), were the 19 who had a recent VCF, whereas the control group (CG) consisted of the remaining 37 patients.MethodsAssessment of P-RB was based on six parameters: grimacing, sighing, clenching or blocking eyelids, gaping or strongly tightening the lips, need for help to take positions, and extreme difficulty to turn in the prone position. A score of 1 or a decimal was assigned to each parameter, the final score to each patient being 0 to 6. Three types of injury, acute (I), subacute (II), or chronic (III), were identified on the basis of the time elapsed from the probable occurrence of the fracture. The diagnosis of recent fracture was based on magnetic resonance images. Patients were videotaped during their movements. An examiner, unaware of the clinical history and diagnosis, gave a P-RB score to all patients and indicated whether they had to be placed in FG or CG, and also their presumable type of fracture. Subsequently, a DVD with the videotapes of all patients was given to three independent examiners, not specifically expert of spine conditions, who were asked to make the same evaluations as the first examiner.ResultsThe mean scores for P-RB given by the first examiner were 4.6 to FG and 0.7 to CG (p<.01). He identified as FPs 89% of those who were in FG. The type of fracture was indicated correctly in 88% of patients identified as FPs. The mean scores for the three types of fracture ranged from 5.4 (Type I) to 3.3 (Type III) (p<.001). The mean scores for P-RB given by the independent examiners to FG and CG were similar to those of the first examiner. The rates of correctness in identifying the type of fracture in patients indicated as FPs varied from 87% to 80%. The mean scores assigned to the patients included in the three types of fracture ranged from 5.4 to 2.8.ConclusionsPain-related behavior evaluation of patients with osteoporotic VCF during their movements on the examining table may allow to suspect, or even diagnose, the presence of a fracture, particularly in the initial 4 to 6 weeks after the occurrence. Even orthopedic surgeons not particularly familiar with spine care may be able to suspect the injury during physical examination.     

云南省德宏州2010—2011年新报告HIV-1感染者中新近感染比例及其影响因素

采用BED HIV-1捕获酶联法(BED Capture EIA,BED-CEIA)可区别近期感染与既往感染以估算新近感染率。云南省德宏州对2010—2011年新报告HIV感染者进行了BED-CEIA检测研究。     

皮质发育障碍伴癫痫发作动物模型的制作

 目的建立X线—匹罗卡品双重干预的皮质发育障碍（DCDs）鼠伴癫痫发作模型。方法将6只SD孕鼠随机分为实验组和正常对照组,实验组孕鼠给予X线照射,正常对照组不做任何处理。待仔鼠出生后60 d观察雄性仔鼠行为、脑电图、大脑形态及皮质和海马的病理改变。60 d的雄性仔鼠腹腔注射氯化锂—匹罗卡品诱发癫痫,比较潜伏期、注射药物总剂量、Ⅴ级癫痫发作率以及行为学和自发性癫痫发作情况。结果与正常对照组雄性仔鼠比较,实验组DCDs雄性仔鼠大脑体积变小,可见明显畸形;HE染色显示皮层变薄,神经元排列紊乱,海马CA1、CA2中断,可见团块状结构;未发现自发性癫痫发作,脑电图无异常放电,有活动增多等表现。注射氯化锂—匹罗卡品后实验组DCDs雄性仔鼠癫痫发作潜伏期缩短（P<0.05）,用药剂量减少（P<0.05）,Ⅴ级发作率增高（P<0.05）;癫痫持续发作后易激惹,具有攻击行为,并在静止期及慢性期出现自发性癫痫发作;HE显示皮层厚度减小。结论X线—匹罗卡品双重干预能成功建立弥漫性DCDs模型,并产生自发性癫痫发作。     

华中地区近代人群上、下颌第一臼齿齿冠及齿尖面积

目的 通过对282枚华中地区新石器时代到明清时期(距今5 000～200年)人类上、下颌骨第一臼齿(M1和M1)齿冠和齿尖面积的测量和分析,取得华中地区近代人群牙齿尺寸的准确数据和变异情况. 方法 采用统一标准对每颗牙齿咬合面行高分辨率摄片.运用数字图像技术与形态测量方法获取每颗牙齿的齿冠绝对面积和单个齿尖相对面积. 结果 齿尖相对面积大小顺序为:M1:原尖>前尖>后尖>次尖;M1:原尖>后尖>下次尖>内尖>下次小尖;M1齿尖相对面积的变异总体上大于M1;从大约5 000年前的新石器时代到明清时期,华中地区人类M1和M1齿冠绝对面积分别缩小了6.57%和6.15%. 结论 食物结构的变化可能是造成臼齿结构变化的主要原因,在此期间M1和M1相对齿尖面积一直保持稳定,提示现代人类相对齿尖大小比例至少在距今5 000年前的新石器时代就已经形成.