Expression of Survivin in Early Villus and Decidua and Its Implication

Survivin isa newly found memberof inhibitorofapoptosis proteins(IAP) ,which is independent ofBcl- 2 proteins,and is expressed in most human ma-lignancy,being abundant in mouse and human em-bryonic and fetal tissues and undetectable in normaladult tissues.Survivin has been shown to be presentin 6 0 cancer celllines,including breast,lung,renal,prostate and ovarian[1] .It hasbeen reported thattheexpression of survivin protein washigh in the glandu-lar epithelial cells during secretory phase of h…     

用PCR技术产前诊断人巨细胞病毒感染

用ＥＬＩＳＡ法筛选早孕妇女血人巨细胞病毒ＩｇＭ（ＨＣＭＶ－ＩｇＭ），在孕１２￣２０周用聚合酶链式反应（ＰＣＲ）技术检测其羊水中ＨＣＭＶ－ＤＮＡ，对胎儿巨细胞病毒感染作出产前诊断。在３８４例孕妇中，筛选出血ＨＣＭＶ－ＩｇＭ阳性２６例为实验组，其羊水ＨＣＭＶ－ＤＮＡ检出率为３４．６２％；从２５８例ＨＣＭＶ－ＩｇＭ阴性中选出２０例为对照组，其羊水ＨＣＭＶ－ＤＮＡ检出率为１０．０％，两组比较有显著性差异（     

董酒珍酒对小鼠血清睾酮皮质醇等的影响

目的　研究贵州产名酒董酒、珍酒的保健作用。方法　采用氢化可的松 (以下简称氢可 )肌注 (每日 1次 ,连续 3d)复制小鼠阳虚症模型 ,用放免法测血清睾酮、皮质醇水平及心、肝、肾、睾丸组织形态学的变化 ,并比较董酒、珍酒对其的影响。结果　肌注氢可的各组血清皮质醇浓度明显增加 ,与正常组比较 ,差异具显著性 (P <0 .0 5 ) ;单纯阳虚组血清睾酮浓度虽不降低 ,但睾丸组织中生精状况差 ;而在阳虚 饮酒组 (董酒或珍酒组 ) ,血清睾酮浓度明显降低 (P <0 .0 5或P <0 .0 1) ,但睾丸组织中生精活跃 ,可见较多的精母细胞、精子细胞等精子发育良好。结论　董酒、珍酒可降低阳虚小鼠血清睾酮水平 ,但对其睾丸生精功能似有一定促进作用 ,其机制有待阐明。     

血塞通治疗早中期糖尿病肾病的临床观察

目的观察注射用血塞通治疗糖尿病肾病(DN)的临床疗效。方法将60例DN患者随机分为治疗组和对照组,对照组在饮食管理的基础上,同时给予降糖、降压治疗,治疗组在对照组的基础上每天加用注射用血塞通静脉滴注,疗程共l5 d。结果治疗组的临床疗效与对照组比较,差异有显著性意义(p<0.05)。治疗组治疗后24 h尿蛋白定量、血肌酐、尿素氮与治疗前比较,差异均有显著性意义(p<0.05),与对照组治疗后比较,差异亦有显著性意义(p<0.05)。对照组治疗前后各生化指标比较,差异均无显著性意义(p>0.05)。结论活血化瘀法治疗DN临床有效。     

Comparison of the Masaoka-Koga staging and the International Association for the Study of Lung Cancer/the International Thymic Malignancies Interest Group proposal for the TNM staging systems based on the Chinese Alliance for Research in Thymomas retrospective database

Background

To compare the predictive effect of the Masaoka-Koga staging system and the International Association for the Study of Lung Cancer (IASLC)/the International Thymic Malignancies Interest Group (ITMIG) proposal for the new TNM staging on prognosis of thymic malignancies using the Chinese Alliance for Research in Thymomas (ChART) retrospective database.

Methods

From 1992 to 2012, 2,370 patients in ChART database were retrospectively reviewed. Of these, 1,198 patients with complete information on TNM stage, Masaoka-Koga stage, and survival were used for analysis. Cumulative incidence of recurrence (CIR) was assessed in R0 patients. Overall survival (OS) was evaluated both in an R0 resected cohort, as well as in all patients (any R status). CIR and OS were first analyzed according to the Masaoka-Koga staging system. Then, they were compared using the new TNM staging proposal.

Results

Based on Masaoka-Koga staging system, significant difference was detected in CIR among all stages. However, no survival difference was revealed between stage I and II, or between stage II and III. Stage IV carried the highest risk of recurrence and worst survival. According to the new TNM staging proposal, CIR in T1a was significantly lower comparing to all other T categories (P<0.05) and there is a significant difference in OS between T1a and T1b (P=0.004). T4 had the worst OS comparing to all other T categories. CIR and OS were significantly worse in N (+) than in N0 patients. Significant difference in CIR and OS was detected between M0 and M1b, but not between M0 and M1a. OS was almost always statistically different when comparison was made between stages I–IIIa and stages IIIb–IVb. However, no statistical difference could be detected among stages IIIb to IVb.

Conclusions

Compared with Masaoka-Koga staging, the IASLC/ITMIG TNM staging proposal not only describes the extent of tumor invasion but also provides information on lymphatic involvement and tumor dissemination. Further study using prospectively recorded information on the proposed TNM categories would be helpful to better grouping thymic tumors for predicting prognosis and guiding clinical management.     

Postoperative survival for patients with thymoma complicating myasthenia gravis—preliminary retrospective results of the ChART database

Background

It is so far not clear that how myasthenia gravis (MG) affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG.

Methods

The Chinese Alliance for Research in Thymomas (ChART) registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, patients were followed and their survival status were analyzed.

Results

There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05). There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05) in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5- and 10-year overall survival (OS) rates were both higher in MG group (93% vs. 88%; 83% vs. 81%, P=0.034) respectively. The survival rate was significantly higher in patients with MG when the Masaoka staging was 3/4 (P=0.003). Among patients with advanced stage thymoma (stage 3, 4a, 4b), the constituent ratios of 3, 4a, 4b were similar between MG and non-MG group. Histologically, however, there were significantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000). Univariate analyses for all patients showed that MG, WHO classification, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were significant factors, and multivariate analysis showed WHO classification, Masaoka stage, and resectability were strong independent prognostic indicators.

Conclusions

Although MG is not an independent prognostic factor, the survival of patients with thymoma was superior when MG was present, especially in late Masaoka stage patients. Possible reasons included early diagnosis of the tumor, better histologic types, an overall higher R0 resection and less recurrence.     

The role of postoperative radiotherapy for stage I/II/III thymic tumor—results of the ChART retrospective database

Background

Postoperative radiotherapy (PORT) for thymic tumor is still controversial. The object of the study is to evaluate the role of PORT for stage I to III thymic tumors.

Methods

The Chinese Alliance for Research in Thymomas (ChART) was searched for patients with stage I to III thymic tumors who underwent surgical resection without neoajuvant therapy between 1994 and 2012. Univariate and multivariate survival analyses were performed. Cox proportional hazard model was used to determine the hazard ratio for death.

Result

From the ChART database, 1,546 stage I to III patients were identified. Among these patients, 649 (41.98%) received PORT. PORT was associated with gender, histological type (World Health Organization, WHO), thymectomy extent, resection status, Masaoka-Koga stage and adjuvant chemotherapy. The 5-year and 10-year overall survival (OS) rates and disease-free survival (DFS) rates for patients underwent surgery followed by PORT were 90% and 80%, 81% and 63%, comparing with 96% and 95%, 92% and 90% for patients underwent surgery alone (P=0.001, P<0.001) respectively. In univariate analysis, age, histological type (WHO), Masaoka-Koga stage, completeness of resection, and PORT were associated with OS. Multivariable analysis showed that histological type (WHO) (P=0.001), Masaoka-Koga stage (P=0.029) and completeness of resection (P=0.003) were independently prognostic factors of OS. In univariate analysis, gender, myasthenia gravis, histological subtype, Masaoka-Koga stage, surgical approach, PORT and completeness of resection were associated with DFS. Multivariate analysis showed that histological subtype (P<0.001), Masaoka-Koga stage (P=0.005) and completeness of resection (P=0.006) were independent prognostic factors for DFS. Subgroup analysis showed that patients with incomplete resection underwent PORT achieved better OS and DFS (P=0.010, 0.017, respectively). However, patients with complete resection underwent PORT had the worse OS and DFS (P<0.001, P<0.001, respectively).

Conclusions

The current retrospective study indicates that PORT after incomplete resection could improve OS and DFS for patients with stage I to III thymic tumors. However for those after complete resection, PORT does not seem to have any survival benefit on the whole.     

Rapid detection for infected ascites in cirrhosis using metagenome next-generation sequencing: A case series

Empirical antibiotic therapy in patients with spontaneous bacterial peritonitis (SBP) is common as pathogen(s) are identified in only 5%-20% patients using conventional culture-based techniques. Metagenome next-generation sequencing (mNGS) test is a promising approach for the diagnosis of infectious disease. The clinical application of mNGS for infected ascites in cirrhotic patients is rarely reported. Here, we describe three cases to preliminarily explore the potential role of mNGS for microbiological diagnosis of ascites infection in an exploratory manner. The clinical performance of ascites mNGS in cirrhotic patients remains to be further evaluated.     

E-cad基因表达与胃癌发生及预后的关系研究

为探讨上皮钙粘附蛋白（E-cad)基因表达与胃癌发生发展及预后的关系，应用免疫组织化学方法检测了65例胃癌，25例胃癌前病变患者及20例胃粘膜正常者标本中的E-cad表达。结果显示，胃癌E-cad异常表达率（53．85％）显著高于胃癌前病变（24．0％），E-cad表达异常与胃癌的临床分期，分化程度，浸润深度及淋巴结转移密切相关，E-cad表达正常胃癌患者的3年，5年生存率显著高于E-cad表达异常者（P＜0．05）。提示E-cad基因表达与胃癌发生发展密切相关，检测E-cad表达有助于胃癌的早期诊断及转移潜能与预后的判断。