Provision of Contraceptive Services to Women with Diabetes Mellitus

BACKGROUND  

Women with diabetes mellitus who delay pregnancy until glycemic control is achieved experience lower rates of adverse pregnancy outcomes.     

Kinetics of testosterone recovery in clinically localized prostate cancer patients treated with radical prostatectomy and subsequent short-term adjuvant androgen deprivation therapy

Androgen deprivation therapy (ADT) is a standard treatment for metastatic, recurrent and locally advanced prostate cancer (PCa). The aim of this study is to investigate the timing and extent of testosterone recovery in clinically localized PCa patients treated with radical prostatectomy (RP) and subsequent short-term adjuvant ADT. A total of 95 localized PCa patients underwent RP and 9-month adjuvant ADT were included in this prospective study. Serum testosterone level was measured before adjuvant ADT, at ADT cessation, and at 1, 3, 6, 9 and 12 months after cessation of ADT. A Cox proportional hazards model was used to assess variables associated with the time of testosterone normalization. The results showed that median patient age was 67 years and median testosterone level before adjuvant ADT was 361 (230–905) ng dl⁻¹. All patients finished 9-month adjuvant ADT and achieved castrate testosterone level. At 3 months after ADT cessation, testosterone recovered to supracastrate level in 97.9% patients and to normal level in 36.9% patients. The percentage of patients who recovered to normal testosterone level increased to 66.3%, 86.3% and 92.6% at 6, 9 and 12 months, respectively. Cox regression model found that higher baseline testosterone level (≥300 ng dl⁻¹) was the only variable associated with a shorter time to testosterone normalization (hazard ratio: 1.98; P = 0.012). In conclusion, in most patients, testosterone recovered to supracastrate level at 3 months and to normal level at 12 months after 9-month adjuvant ADT cessation. Patients with higher baseline testosterone level need shorter time of testosterone normalization.     

山茱萸总苷对大鼠实验性变态反应性脑脊髓炎的初步观察

目的：观察山茱萸总苷（TGCO）对大鼠实验性变态反应性脑脊髓炎（EAE）的影响。方法：Wistar大鼠24只随机分为3组：正常对照组、EAE组和TGCO组。采用动物行为学、常规苏木精-伊红染色和LFB髓鞘染色观察大鼠的发病情况与中枢神经系统（CNS）的病理变化。结果：EAE组7／8只大鼠出现典型的EAE行为学改变、CNS炎性细胞浸润和髓鞘脱失。TGCO组有3,8只大鼠出现EAE行为学改变,评分最高为29,潜伏期延长,CNS内炎性细胞浸润和髓鞘脱失明显减轻。对照组未见动物行为学和CNS病理学改变。结论：TGCO能减轻EAE大鼠的临床症状、延长潜伏期和降低发病率。     

Neutrophil/eosinophil-rich type of primary cutaneous anaplastic large cell lymphoma: a clinicopathological, immunophenotypic and molecular study of nine cases

Aims:  To elucidate the clinicopathological, immunophenotypic and molecular features of neutrophil/eosinophil-rich primary cutaneous anaplastic large cell lymphoma (CALCL), and to emphasize the cutaneous manifestations, differential diagnosis and prognosis of this peculiar entity.
Methods and results:  We described the clinical presentations, histopathology, immunophenotype, molecular features and follow-up courses of nine neutrophil/eosinophil-rich CALCL cases. Various clinical lesions including multiple nodules, plaques and solitary exophytic masses with or without ulceration or crusting were noted in nine patients. Two patients died of disease progression, with one developing multiple lymph node involvement. Histologically, cohesive sheets or small clusters of neoplastic cells were admixed with large numbers of neutrophils and/or eosinophils, representing 10–40% of cells per high-power field. All nine cases showed T-cell phenotypes. The frequency of rearranged TCRB , TCRG and TCRD genes in six cases with available paraffin-embedded tissue was 100%, 83% and 33%, respectively.
Conclusions:  Neutrophil/eosinophil-rich CALCL should be differentiated from various infectious and non-infectious diseases, especially from non-neoplastic cutaneous CD30+ infiltrates rich in neutrophils and eosinophils. Precise correlation of clinical presentation, morphological features, phenotypic and molecular analysis can help to establish the correct diagnosis. Whether this rare variant has a significantly different prognosis from classical CALCL needs further investigation.     

银杏叶提取物对大鼠脑缺血再灌时脑电图的作用

AIM:To test the effect of Grinkgo biloba leaf extract on electroencephalography(EEG) during cerebral ischemia and reperfusion.METHODS:Based on the quantitative analysis of EEG using the fast Fourier transform(FFT), the effect of Ginkgo biloba extract(GbE) on rat EEG was surveyed in the model of middle cerebral artery (MCA) occlusion and global cerebral ischemia.Results:In the golbal cerebral ischemia,GbE 8 and 16 mg/kg could accelerate the recovery of EEG after reperfusion,and GbE4 mg/kg had the same effect but much weaker,In the MCA occlusion model GbE 16 and 32 mg/kg greatly supressed the drop of power spectrum of EEG.CONCLUSION:GbE could mitigate the cerebral damage caused by ischemia.     

Intravascular large B-cell lymphoma with cutaneous manifestations: a clinicopathologic, immunophenotypic and molecular study of three cases

Background:  Intravascular large B-cell lymphoma (IVLBCL) is an extremely rare type of malignant lymphoma characterized by exclusive or predominant growth of neoplastic cells within the lumen of blood vessels. Cases in the literature predominantly involve the skin and central nervous system, with special emphasis on the 'cutaneous variant'.
Methods:  Three cases of IVLBCL with cutaneous manifestations, including two systemic IVLBCL and one cutaneous variant, were described in this study. In all cases, clinical presentation and follow-up data were meticulously evaluated and immunophenotypic and molecular studies were performed.
Results:  All three cases displayed the B-cell phenotype and showed monoclonality with immunoglobulin heavy chain gene rearrangement. Bcl2 was expressed in the two systemic IVLBCL cases with fatal outcomes. The third patient with the 'cutaneous variant' achieved complete remission and a longer survival time of 15 months after chemotherapy.
Conclusions:  Skin manifestations and neurological findings, although to different degrees, are important clues to the diagnosis of IVLBCL. As most IVLBCL are grouped into the post-germinal center B-cell subtype of diffuse large B-cell lymphoma, Bcl2 expression may be correlated with a worse prognosis in IVLBCL. The cutaneous variant of IVLBCL has a significantly better outcome than that of systemic IVLBCL.     

Combination of circulating tumor cell enumeration and tumor marker detection in predicting prognosis and treatment effect in metastatic castration-resistant prostate cancer

Although circulating tumor cell (CTC) enumeration in peripheral blood has already been validated as a reliable biomarker in predicting prognosis in metastatic castration-resistant prostate cancer (mCRPC), patients with favorable CTC counts (CTC < 5/7.5 ml) still experience various survival times. Assays that can reduce patients'' risks are urgently needed. In this study, we set up a real-time quantitative polymerase chain reaction (RT-qPCR) method to detect epithelial-mesenchymal transition (EMT) and stem cell gene expression status in peripheral blood to validate whether they could complement CTC enumeration. From January 2013 to June 2014 we collected peripheral blood from 70 mCRPC patients and enumerated CTC in these blood samples using CellSearch system. At the same time, stem cell-related genes (ABCG2, PROM1 and PSCA) and EMT-related genes (TWIST1 and vimentin) were detected in these peripheral blood samples using an RT-qPCR assay. Patient overall survival (OS) and treatment methods were recorded in the follow-up. For patients who received first-line chemotherapy, docetaxel plus prednisone, PSA progression-free survival (PSA-PFS) and PSA response rate were recorded. At the time of analysis, 35 patients had died of prostate cancer with a median follow-up of 16.0 months. Unfavorable CTC enumerations (CTC ≥5/7.5 ml) were predictive of shorter OS (p = 0.01). Also, positive stem cell gene expression indicated poor prognosis in mCRPC patients (p = 0.01). However, EMT gene expression status failed to show any prognostic value in OS (p = 0.78). A multivariate analysis indicated that serum albumin (p = 0.04), ECOG performance status (p < 0.01), CTC enumeration (p = 0.02) and stem cell gene expression status (p = 0.01) were independent prognostic factors for OS. For the 40 patients categorized into the favorable CTC enumeration group, positive stem cell gene expression also suggested poor prognosis (p < 0.01). A combined prognostic model consisting of stem cell gene expression and CTC enumeration increased the concordance probability estimated value from 0.716 to 0.889 in comparison with CTC enumeration alone. For patients who received docetaxel plus prednisone as first-line chemotherapy, positive stem cell gene expression suggested a poor PSA-PFS (p = 0.01) and a low PSA response rate (p = 0.008). However, CTC enumeration and EMT gene expression status did not affect PSA-PFS or PSA response rates. As a result, detection of peripheral blood stem cell gene expression could complement CTC enumeration in predicting OS and docetaxel-based treatment effects in mCRPC patients.     

Low-level mosaicism for trisomy 16 at amniocentesis in a pregnancy associated with intrauterine growth restriction and a favorable outcome

ObjectiveWe present low-level mosaicism for trisomy 16 at amniocentesis in a pregnancy associated with intrauterine growth restriction (IUGR) and a favorable outcome.Case reportA 31-year-old woman underwent amniocentesis at 24 weeks of gestation because of IUGR. Amniocentesis revealed a karyotype of 47,XX,+16 [3]/46,XX [22]. Simultaneous array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniocytes revealed gene dosage increase in chromosome 16 consistent with 28% mosaicism for trisomy 16. Uniparental disomy (UPD) 7 and UPD 11 were excluded. She underwent repeat amniocentesis at 27 weeks of gestation. Repeat amniocentesis revealed a karyotype of 47,XX,+16 [1]/46,XX [24]. Simultaneous aCGH analysis on the DNA extracted from uncultured amniocytes revealed 25%–35% (log₂ ratio = 0.17–0.25) mosaicism for trisomy 16. Interphase fluorescence in situ hybridization (FISH) analysis detected trisomy 16 signals in 28/100 (28%) uncultured amniocytes. Polymorphic DNA marker analysis excluded UPD 16. Level II ultrasound revealed no fetal abnormalities except symmetric IUGR. The pregnancy was continued to 37 weeks of gestation, and a 2306-g phenotypically normal baby was delivered. The cord blood had a karyotype of 46, XX in 50/50 lymphocytes. The umbilical cord had a karyotype of 47,XX,+16 [14]/46,XX [36]. Interphase FISH analysis on buccal mucosal cells and urinary cells at age three days revealed trisomy 16 signals in 3.8% (4/106) buccal mucosal cells and 6.5% (7/107) urinary cells, compared with 1% in the normal control. Polymorphic DNA marker analysis on placenta confirmed trisomy 16 in the placenta and a maternal origin of the extra chromosome 16.ConclusionCytogenetic discrepancy between cultured amniocytes and uncultured amniocytes may present in mosaic trisomy 16 at amniocentesis. Low-level mosaicism for trisomy 16 at amniocentesis without maternal UPD 16 can be associated with a favorable outcome despite the presence of IUGR.     

江苏省血吸虫病查病质控体系的构建与应用 Ⅱ 县级人员病原学检测能力评估

目的 评价江苏省县级血防机构开展血吸虫病病原学检测水平,提高专业技术人员血吸虫病病原学检测能力,为构建血吸虫病现场查病质控体系提供技术支撑。方法 人工获取家兔血吸虫肝卵,制备成4个不同浓度的虫卵悬液,采用单盲法开展虫卵孵化检测,比较县级工作员检测结果与标准结果的符合率、误检率和漏检率。结果 江苏省28个县（市、区）共检测虫卵悬液560份,检出阳性283份,阴性203份,总符合率为86.79%,总误检率为9.38%,总漏检率为15.77%,检测结果与标准结果差异有统计学意义（[χ2] = 12.99,P < 0.01）。28个县（市、区）中有20个县（市、区）出现了漏检,占71.43%;13个县（市、区）出现了误检,占46.43%。江滩、山丘、水网和湖滩4类地区病原学检测误检率为4.55%～43.75%,差异有统计学意义（[χ2] =30.34, P < 0.01）;漏检率为4.17%～20.45%,差异无统计学意义（[χ2] = 5.09,P = 0.17）。传播控制和传播阻断2类流行区病原学检测误检与漏检率分别为7.50%、13.33%与10.42%、17.13%,差异无统计学意义（[χ2] = 0.229、0.575,P 均> 0.05）。达到血吸虫病传播控制10年及以上和不足10年地区误检与漏检率分别为11.81%、5.00%与16.67%、14.17%,差异无统计学意义（[χ2] = 2.804、2.848,P均 > 0.05）。达到血吸虫病传播阻断10年及以上与不足10年地区误检率分别为11.54%与10.00%,差异无统计学意义（[χ2] = 0.069,P = 0.792）;漏检率分别为10.90%与35.00%,差异有统计学意义（[χ2] = 17.364,P < 0.01）。结论 江苏省县级水平血吸虫病查病工作存在漏检、误检现象,现场病原学检测能力有待进一步提高。