Analysis of syphilis antibody results in pregnant women and newborns detected by automatic chemiluminescent immunoassay / 中华检验医学杂志

Objective:To examine the distribution of syphilis antibody in pregnant women and newborns and to explore how to optimize the existing syphilis screening process by setting the diagnostic gray area.Methods:The results of syphilis testing obtained from 119 531 pregnant women and 21 275 newborns from 2015 to 2018 by automatic chemiluminescent immunoassay (CLIA) and the re-examination results determined by Treponema pallidum particle agglutination (TPPA) and the rapid plasma reagin test (RPR) were retrospective analyzed. Data analysis was performed by Chi-square, Fisher′s exact test and Chi-square test for trend. Results:The positive rates of Syphilis specific antibody (TPAb) in clinical specimens from pregnant women and newborns were 0.69% (825/119 531) and 1.24%(264/21 275). The total re-examination positive rates were 0.32% (380/119 531) and 0.90%(191/21 275), and the suspicious syphilis prevalence rates in these specimens were 0.13% (161/119 531) and 0.31%(67/21 275), respectively. The suspicious syphilis prevalence rates in specimens of pregnant women from 2015 to 2018 and newborns increased year by year (χ 2=9.860, P=0.002; χ 2=5.311, P=0.021). With the elevation of the optical density value of samples to cut-off ratio (S/CO) value, positive coincidence rate of TPPA and TPAb in pregnant women and newborns increased significantly (χ 2=614.833, P<0.001; P<0.001). When the S/CO value in newborns exceeded 7.00 or the S/CO value in pregnant women exceeded 15.00, the effectiveness of TPAb results is equivalent to TPPA. The prevalence of suspected syphilis in pregnant women and newborns also increased with the increase of S/CO value (χ 2=323.059, P<0.001; P<0.001). When the S/CO value in newborns bellowed 3.00 or the S/CO value in pregnant women bellowed 5.00, the prevalence rate of suspected syphilis was 0%, which could preliminarily exclude syphilis infection. Conclusions:The prevalence rates of suspected syphilis in pregnant women was increasing during the recent years. It is necessary to further strengthen syphilis screening and intervention treatment in early pregnancy to improve the rate of eugenics. Being a primary screening method for syphilis in pregnant women and newborns, CLIA has high false positive rate. According to the gray area established in this study, the syphilis screening process can be optimized to prevent missed detection, which may reduce the false positive rate and avoid clinical misdiagnosis.

Inhibition of glutathione metabolism attenuates esophageal cancer progression

Esophageal squamous cell carcinoma (ESCC) is a deadly malignancy with regard to mortality and prognosis, and the 5-year survival rate for all patients diagnosed with ESCC remains poor. A better understanding of the biological mechanisms of ESCC tumorigenesis and progression is of great importance to improve treatment of this disease. In this study, we demonstrated that the glutathione metabolism pathway is highly enriched in ESCC cells compared with normal esophageal epithelial cells in an in vivo mouse model. In addition, treatment with L-buthionine-sulfoximine (BSO) to deplete glutathione decreased the ESCC tumor burden in mice, thus demonstrating the critical role of glutathione metabolism in ESCC progression. BSO treatment also led to decreased cell proliferation and activation of cell apoptosis in ESCC. Finally, BSO treatment blocked NF-κB pathway activation in ESCC. Our study reveals a new pathway that regulates ESCC progression and suggests that inhibition of glutathione metabolism may be a potential strategy for ESCC treatment.

Effect of intermittent use of low-dose urokinase on pulmonary embolism / 实用医学杂志

Objective To evaluate the efficacy and safety of intermittent use of low-dose urokinase in the treatment of pulmonary embolism. Methods Forty-two patients with acute pulmonary embolism were divided into UK group with UK 10 000 U/(kg·d),7 days and rt-PA group with rt-PA 50 mg/2 h randomly. The efficacy was determined by the improvement of right heart dysfunction and perfusion defect 8 d and 14 d after the treatment. The bleeding incidence, death rate and PE recurrence were also evaluated. Results Differences of right heart dysfunction and perfusion defect between UK group and rt-PA group indicated no statistical significance (P >0.05).The rate of bleeding in UK group was lower than that of rt-PA group. Conclution The intermittent use of low-dose urokinase in the treatment of pulmonary embolism exhibits similar efficacy as rt-PA.

A proliferation-inducing ligand expression in breast cancer and its relationship with prognosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the relationship between a proliferation-inducing ligand (APRIL) expression in primary tumor foci of breast cancer and the patients' prognosis.</p><p><b>METHODS</b>Paraffin sections of surgical specimens were retrospectively collected from 130 stage I-III breast cancer patients who received surgery between January 2000 and December 2002 in our hospital. Immunohistochemistry was used to assess APRIL expression intensity in the tumor cells and density of interstitial APRIL-positive cells, and their association was analyzed with the density of interstitial CD4⁺ and CD8⁺ cells and with the histopathologic features, overall survival (OS), and disease-free survival (DFS) of the patients.</p><p><b>RESULTS</b>APRIL positive staining was found in the cytoplasm of the tumor cells, interstitial cells, and the extracellular matrix. APRIL intensity in the tumor cells was positively correlated with the density of interstitial APRIL-positive cells (P=0.009) and Ki67 (P=0.003). The density of interstitial APRIL-positive cells was positively correlated with the density of interstitial CD4⁺ cells (P<0.001) and CD8⁺ cells (P<0.001). In hormone receptor negative patients (ER- and PR-), multivariate COX regression identified the density of interstitial APRIL-positive cells as a positive prognostic factor for DFS (HR=0.313, 95% CI=0.107-0.920, P=0.035). CONCLUSIONSl APRIL is widely expressed in the interstitial immune cells in breast cancer. APRIL staining intensity in the tumor cells is positively correlated with tumor proliferation, indicating that the immune cells might promote tumor proliferation by secreting APRIL. A greater density of interstitial APRIL-positive cells is associated with a good prognosis in hormone receptor-negative patients.</p>

Prognostic value of B lymphocyte infiltration in breast cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the prognostic value of CD20(+) tumor-infiltrating lymphocytes (TILs) in early-stage breast cancer.</p><p><b>METHODS</b>Paraffin sections were collected from 130 cases of stage I-III breast cancer undergoing surgery between January, 2000 and December, 2002 in our hospital. Immunohistochemistry was used to analyze mesenchymal CD20(+) TILs infiltration in the tumor and evaluate its association with the density of CD4(+) and CD8(+) TILs. The association of CD20(+) TILs was evaluated with the histopathologic features, overall survival (OS), distant disease-free survival (DDFS), and disease-free survival (DFS) of the patients.</p><p><b>RESULTS</b>Aggregations of CD20(+) lymphocytes were observed in 37.69% (49/130) of the cases. CD3(+) T cells were found to aggregate around CD20(+) B cell aggregations to form lymphoid follicle-like structures. The aggregations of CD20(+) TILs were positively correlated with the densities of mesenchymal CD8+ and CD4(+) TILs. Overall, CD20(+) TIL aggregations were not significantly correlated with the outcomes of the patients, but multivariate COX regressions suggested that CD20(+) TIL aggregations were positively correlated with DDFS (HR=0.251, 95% CI=0.071-0.894, P=0.033) and OS (HR=0.325, 95% CI=0.103-1.028, P=0.056) in hormone receptor-negative patients but not in the positive patients. Further analysis suggested that post-operative adjuvant endocrine therapy significantly improved the OS of patients positive for hormone receptors without CD20(+) TIL aggregations (P=0.001).</p><p><b>CONCLUSION</b>The long-term therapeutic effects of adjuvant endocrine therapy are correlated with CD20(+) TIL aggregations to affect prognostic value of CD20(+) TIL aggregations in early-stage breast cancer patients.</p>

Safety and feasibility of fast track surgery in operations for gastric cancer: a meta analysis / 中华消化外科杂志

Objective To estimate the safety and feasibility of fast track surgery (FTS) in operations for gastric cancer.Methods The Cochrane library,PubMed,EMBASE,Chinese biomedical literature database,China journal full text database,Chinese scientific journals full text database were searched with the key words of gastric cancer,gastric carcinoma, FTS,fast track surgery, enhanced recovery after surgery,ERAS, 胃癌,and 快速康复外科.The search was finished in April,2011.Randomized controlled trials of FTS for patients with gastric cancer were included.Two reviewers evaluated the quality of the included studies and extracted the data independently.Meta analysis was performed by RevMan 5.1.2 software.Results Fourteen randomized controlled trials involving 1270 patients were included.The results of meta analysis showed that FTS could significantly shorten the first exhaust time (MD =-6.15,95 ％ confidence interval:-8.22- -4.07,P＜ 0.05) and hospital stay ( MD =- 2.68,95％ confidence interval:- 3.26- - 2.10,P ＜ 0.05 ),and reduced the hospital fees ( MD =- 0.39,95 ％ confidence interval:- 0.55- - 0.22,P ＜ 0.05 ).FTS could lighten the postoperative stress and relatively enhance the immunity.Conclusion Compared with conventional methods,FTS could speed up the rehabilitation for patients with gastric cancer postoperatively without increasing the adverse reactions.

Percutaneous cryoablation of cervical lymph node metastases under ultrasonic guidance / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the feasibility and safety of cryoablation of cervical lymph node metastases for nonsurgical candidates.METHODS The procedure was performed after achievement of local anesthesia for 15 cases.In this clinical study,local anesthesia with no sedation was performed to all the patients.In all cases,patients underwent two freeze/thaw cycles.RESULTS Tumors of 14 patients were thoroughly covered by ice balls.In one patient,96% of the tumorous lesion was covered by ice balls.In these patients,no complicated complication was observed during the treatment.CONCLUSION Percutaneous cryoablation therapy for cervical lymph node metastases under ultrasonic guidance is a feasible and minimally invasive method with satisfactory local control.

Synergistic Cytotoxicity of Chemotherapeutic Agents and Tumor Necrosis Factor ? against Hepatic Carcinoma Cells in vitro / 中国肿瘤生物治疗杂志

The synergistic cytotoxicity of rhTNF-? or/and six chemotherapeutic agents namely ADM, MMC, DDP, VP-16, GBP and IFO, against two human hepatic carcinoma cell lines, SMMC-7721 and BEL-7402, was examined by MTT assay. The results showed that the cytotoxic effects of six chemotherapeutic agents with rhTNF-? against two cell lines were significant. Examined cytotoxicity of rhTNF-? combined with chemotherapeutic agents, we found that rhTNF-? singnificantly enhanced cytotoxic efficacy of ADM, DDP, VP-16. The study suggested that rhTNF-? with some chemotherapeutic agents had synergistic effects. This and other preclinical studies with rhTNF-? will form the basis of clinical treatments for hepatic carcinoma patient.