Acute pancreatitis combined with acute Budd-Chiari syndrome as the initial manifestation of small cell lung cancer.

Tumor metastasis to the pancreas is a rare but recognized cause of acute pancreatitis. Autopsy series have reported a 24-40% of pancreatic involvement in small cell lung cancer. However, only a very few cases of tumor-induced acute pancreatitis have been described. Budd-Chiari syndrome complicating lung cancer is a rarely reported condition. We report a 68-year-old woman with extensive small cell lung cancer with the unusual initial presentation of both acute pancreatitis and acute Budd-Chiari syndrome. This patient suffered from progressive epigastralgia for 3 weeks. Severe epigastralgia with radiation to back and progressive jaundice developed 2 days prior to admission. After admission, the liver enlarged rapidly and the ascites increased markedly. Chest roentgenogram showed a mass lesion over the left lower lung field. Poorly differentiated carcinoma cells were found in ascites and bone marrow. The patient died on the ninth day of hospitalization before chemotherapy was initiated. Prompt diagnosis of extensive-stage small cell lung cancer may allow early chemotherapy treatment which favorably influences recovery when the pancreatitis is mild. Although prolonged survival might have been expected had this patient recovered from pancreatitis and received chemotherapy, diagnosis was delayed due to difficulty in immunohistochemical diagnosis of the tumor and the unusual clinical presentation. The use of stains employing antibodies against neurofilament and neuron-specific enolase cell antigens is important for early diagnosis of poorly differentiated metastatic tumor cells.     

Association between Reduced Serum Zinc and Diastolic Dysfunction in Maintenance Hemodialysis Patients

Diastolic dysfunction is an emerging challenge among hemodialysis (HD) patients, and the associations between serum zinc with echocardiographic parameters and diastolic function remain uncertain. A total of 185 maintenance HD patients were stratified by the tertiles of serum zinc level to compare their clinical characteristics and echocardiography. Correlations of serum zinc levels with echocardiographic parameters were examined using Pearson’s analysis. Univariate and multivariate logistic regression analyses were performed to investigate the determinants of E/e’ ratio >15 and left atrial volume index (LAVI) > 34 mL/m², both indicators of diastolic dysfunction. Patients belonging to the first tertile of serum zinc level had a significantly higher E/e’ ratio and LAVI. Serum zinc levels were negatively correlated with E (r = −0.204, p = 0.005), E/e’ ratio (r = −0.217, p = 0.003), and LAVI (r = −0.197, p = 0.007). In a multivariate analysis, older age, diabetes, coronary artery disease, and lower serum zinc levels (OR = 0.974, 95% CI = 0.950–0.999, p = 0.039) were significantly associated with E/e’ ratio >15. Furthermore, diabetes and lower serum zinc levels (OR = 0.978, 95% CI = 0.958–0.999, p = 0.041) were significantly associated with LAVI >34 mL/m². Reduced serum zinc level was significantly associated with diastolic dysfunction among HD patients. Further prospective studies are warranted to investigate whether zinc supplementation can attenuate cardiac dysfunction in maintenance HD patients.     

福尔马林固定石蜡包埋组织DNA提取方法对PCR的影响

目的：比较多种福尔马林固定石蜡包埋组织ＤＮＡ提取方法对ＰＣＲ的影响,探讨临床组织病理标本理想的ＤＮＡ提取方法及ＰＣＲ应用。方法：采用５种不同的ＤＮＡ提取方法应用ＰＣＲ技术进行了比较。结果：Ｔｗｅｅｎ ２０,ＮＰ ４０加蛋白酶Ｋ法和亚氨基二乙酸法处理标本时ＰＣＲ结果较为理想。结论：合适的福尔马林固定石蜡包埋组织ＤＮＡ提取方法可应用ＰＣＲ进行ＤＮＡ水平的相应的研究。     

RP-HPLC进行甲氨蝶呤血药浓度监测时保留时间校准方法研究

目的 建立RP—HPLC进行MTX血药浓度监测时保留时间校准方法。方法应用容量因子与流动相比例的三次方多项式模型，建立MTX流动相比例与保留时间的函数，并通过此函数用保留时间求算流动相比例，与理论流动相比例比较，从而计算流动相应该补充组分的量，达到调整保留时间的目的。结果四种不同色谱条件下容量因子与流动相比例的三次方多项式模型拟合关系良好，R0均为1．000，保留时间经校准后RSD为0.9％(n=5)。结论本方法能准确校准因流动相比例引起变化的保留时间，适用于MTX血药浓度监测时保留时间的校准，方法新颖、有效、简单。     

环丙沙星、氧氟沙星及左氧氟沙星对大鼠致痫作用的研究

目的　观察氧氟沙星 (OFL X)和左氧氟沙星 (L VL X)对大鼠中枢神经的毒性与环丙沙星 (CPL X)毒性的差异 ,及抗痫药物对环丙沙星引发的癫痫的阻断作用。方法　 Wistar大鼠 ,随机分为 3组 ,以用药前皮层脑电图 (ECOG)其脑电图功率谱作为自身对照。颈静脉注射药物 10 0 mg/kg,记录给药后 10、2 0、30、6 0、12 0 min时的 ECOG和脑电图 ,及大鼠的行为变化 ,并在癫痫发作后静脉注射抗痫药物 ,阻断癫痫发作。结果　CPL X组大鼠中 7只 ECOG出现棘波和慢棘波 ,其中 5只大鼠 ECOG出现频发棘波 ,频发棘波能被地西泮迅速阻断。用药后 10 min脑电功率谱 δ波功率和总功率较用药前明显降低 (P<0 .0 5 ) ,之后又逐渐升高。用药后θ、α、β波功率逐渐升高 ,12 0 min时明显高于给药前 (P<0 .0 5 ) ;OFL X、L VL X组大鼠 ECOG均无异常改变 ,脑电功率谱δ、θ、α、β波功率及总功率与用药前比较均无显著性差异 (P<0 .0 5 )。但 L VL X组的 ECOG,脑电功率谱δ、θ、α、β波功率及总功率均较 OFL X组变化小。结论　 CPL X对大鼠有明显的致痫作用 ,OFL X和 L VL X无致痫作用 ,且 L VL X组大鼠 ECOG、脑电功率谱变化最小。地西泮对 CPL X引发的大鼠癫痫有阻断作用。     

Changes and significance of plasma fibrinogen gamma‐chain concentration in preeclampsia patients

ObjectiveTo investigate the plasma fibrinogen gamma‐chain concentration in preeclampsia patients and explore its value in preeclampsia prediction and auxiliary diagnosis.MethodsFollow‐up of pregnant women who regularly attended perinatal care at two hospitals in China was performed, and clinical data and plasma samples were collected at each examination until delivery. The gamma‐chain concentration was detected by Western blotting, and Quantity One Software was used for gamma‐chain grayscale value measurements.ResultsForty‐two patients with preeclampsia and 42 control patients completed the follow‐up. In the control group, the gamma‐chain concentration at 32 weeks of gestation was higher than that at 20 weeks of gestation, but the difference was not statistically significant (p > 0.05). In the experimental group, the gamma‐chain concentration at preeclampsia diagnosis was significantly higher than that at 20 weeks of gestation (p < 0.05). Compared with the control group, the gamma‐chain concentration was higher at 20 weeks of gestation in the experimental group, but the difference was not statistically significant. However, at 32 weeks of gestation and at the time of diagnosis, the gamma‐chain concentration in the experimental group was significantly higher than that in the control group (p < 0.05). At 32 weeks of gestation and at the time of diagnosis, the AUCs from ROC curve analysis of plasma fibrinogen gamma‐chain concentrations were 0.64 and 0.71, respectively.ConclusionPlasma fibrinogen synthesis and degradation were disrupted in preeclampsia patients before and after diagnosis, and gamma‐chain concentration was significantly increased. Plasma fibrinogen gamma chain may be of some value in preeclampsia prediction and auxiliary diagnosis.     

Isolation of human lymphatic malformation endothelial cells, their in vitro characterization and in vivo survival in a mouse xenograft model

Human lymphatic vascular malformations (LMs), also known as cystic hygromas or lymphangioma, consist of multiple lymphatic endothelial cell-lined lymph-containing cysts. No animal model of this disease exists. To develop a mouse xenograft model of human LM, CD34^NegCD31^Pos LM lymphatic endothelial cells (LM-LEC) were isolated from surgical specimens and compared to foreskin CD34^NegCD31^Pos lymphatic endothelial cells (LECs). Cells were implanted into a mouse tissue engineering model for 1, 2 and 4 weeks. In vitro LM-LECs showed increased proliferation and survival under starvation conditions (P < 0.0005 at 48 h, two-way ANOVA), increased migration (P < 0.001, two-way ANOVA) and formed fewer (P = 0.029, independent samples t test), shorter tubes (P = 0.029, independent samples t test) than foreskin LECs. In vivo LM-LECs implanted into a Matrigel?-containing mouse chamber model assembled to develop vessels with dilated cystic lumens lined with flat endothelium, morphology similar to that of clinical LMs. Human foreskin LECs failed to survive implantation. In LM-LEC implanted chambers the percent volume of podoplanin^Pos vessels was 1.18 ± 2.24 % at 1 week, 6.34 ± 2.68 % at 2 weeks and increasing to 7.67 ± 3.60 % at 4 weeks. In conclusion, the significantly increased proliferation, migration, resistance to apoptosis and decreased tubulogenesis of LM-LECs observed in vitro is likely to account for their survival and assembly into stable LM-like structures when implanted into a mouse vascularised chamber model. This in vivo xenograft model will provide the basis of future studies of LM biology and testing of potential pharmacological interventions for patients with lymphatic malformations.