Clinical utility of anti-DFS70 for identifying antinuclear antibody-positive patients without systemic autoimmune rheumatic disease

INTRODUCTION@#The antinuclear antibody (ANA) test is a screening test for systemic autoimmune rheumatic disease (SARD). We hypothesised that the presence of anti-DFS70 in ANA-positive samples was associated with a false-positive ANA test and negatively associated with SARD.@*METHODS@#A retrospective analysis of patient samples received for ANA testing from 1 January 2016 to 30 June 2016 was performed. Patient samples underwent ANA testing via indirect immunofluorescence method and anti-DFS70 testing using enzyme-linked immunosorbent assay.@*RESULTS@#Among a total of 645 ANA-positive samples, the majority (41.7%) were positive at a titre of 1:80. The commonest nuclear staining pattern (65.5%) was speckled. Only 9.5% of ANA-positive patients were diagnosed with SARD. Anti-DFS70 was found to be present in 10.0% of ANA-positive patients. The majority (51/59, 86.4%) of patients did not have SARD. Seven patients had positive ANA titre > 1:640, the presence of anti-double stranded DNA and/or anti-Ro60. The presence of anti-DFS70 in ANA-positive patients was not associated with the absence of SARD (Fisher's exact test, p = 0.245).@*CONCLUSION@#The presence of anti-DFS70 was associated with a false-positive ANA test in 8.6% of our patients. Anti-DFS70 was not associated with the absence of SARD.

Postoperative Survival of Triple Negative Breast Cancer Patients After High Exposure to Traditional Chinese Medicine： A Cohort Study / 中国实验方剂学杂志

Objective:To evaluate the 3-year survival outcomes of postoperative patients after high exposure to traditional Chinese medicine （TCM） for triple negative breast cancer （TNBC）. Method:The complete 3-year follow-up data of 150 postoperative patients with stage I–III TNBC were retrospectively analyzed. All the patients received routine western medical treatments （surgery， chemotherapy， and/or radiotherapy） according to the National Comprehensive Cancer Network （NCCN） clinical practice guidelines in oncology as well as TCM. According to the degree of exposure to TCM， they were divided into the high- and low-exposure cohorts， with the oral administration of Chaihu Longmu Decoction with or without anti-cancer Chinese patent medicine for at least six months annually， or 18 months or more in the three years as the inclusion criterion for the former cohort. The metastatic sites of recurrent TNBC and the recurrent metastasis/death time were observed in both cohorts to compare the disease-free survival （DFS） and overall survival （OS）. The influences of onset age， pathological type， histopathological grade， vascular invasion， clinical stage， and exposure to TCM on survival were subjected to statistical analysis， followed by the observation of adverse effects. Result:There was no significant difference in the metastatic sites between the two cohorts （<italic>P</italic>>0.05）. The high-exposure cohort had a longer 3-year DFS than the low-exposure cohort， and the 3-year DFS rate in the high-exposure cohort was increased by 16.9% （χ²=6.995， <italic>P</italic>=0.008） as compared with that in the low-exposure cohort， exhibiting a significant difference （<italic>P</italic><0.05）. As revealed by the Cox proportional-hazards model， patients in the low-exposure cohort had a 3.724-fold as high risk of recurrent metastasis as that in the high-exposure cohort （95%CI 1.399~9.915）. There was no significant difference in the 3-year OS between the two cohorts （<italic>P</italic>>0.05）. The overall incidence of adverse effects in both groups was 7.3%， mainly manifested as gastrointestinal discomfort. Conclusion:High exposure to TCM contributes to reducing postoperative recurrence and metastasis and prolonging DFS.

Assessment of vaccine management in cold chain points of Jashpur and Sarguja districts of Chhattisgarh

Background: It has been observed that besides intensification of routine immunization, more strategic interventions are essential to strengthen the different aspects of immunization services like cold-chain management and monitoring/supportive supervision. The present study was considered as a part of ongoing UNICEF funded project on Supportive Supervision of Routine Immunization in Jashpur and Sarguja districts undertaken by the Department of Community Medicine, GMC Rajnandgaon with the objectives to assess the status of cold chain equipment and logistics management practices, knowledge and practice of cold chain handler (CCHs) about cold chain equipment and logistics management.Methods: A cross-sectional facility based study was conducted from August 2017 to February 2018. Among 18 cold chain points (CCPs), 9 from Jashpur and 9 from Sarguja district were considered for analysis using structured questionnaires provided by UNICEF.Results: In 83.33% CCPs cold chain technician or annual maintenance contract/computer-mediated communication service provider visit for preventive maintenance in the last 4 months. Vaccine CCHs carries out the daily and weekly planned preventive measures as per the checklist in 83.33% CCPs during our visit. In all CCPs iced line refrigerator (ILR) and deep freezer (DF) were placed as per specified guidelines. In 66.66% CCPs there was documentation of monthly review of temperature records. In all CCPs visited standard vaccine and logistics stock/issue registers were available.Conclusions: Most of the components of cold chain and logistics management practices were satisfactory while there is a gap in other components which needs to be improved by means of ongoing project of strengthening of SSRI in both districts.

Evaluation of vaccine storage and cold chain management practices during intensified mission Indradhanush in community health centers of Tikamgarh district of Madhya Pradesh

Background: Vaccination is one of the most effective disease prevention strategies and potency of vaccine is dependent on effective management of cold chain at all levels of vaccine handling. An effective cold chain maintenance system is the backbone of success of any immunization program. This study was done to assess the cold chain management and vaccine storage practices in Tikamgarh district of Madhya Pradesh.Methods: Cross-sectional study was carried out using a structured questionnaire.Results: Dedicated room/space for dry storage not available in any of 03 CHCs. Dedicated table for conditioning of icepacks, dedicated clean clothes for wiping of icepacks after conditioning and power back up was available, ILR and DF were connected to separate functional voltage stabilizer and thermometers were placed correctly only in 66.6% CHCs. ILRs and DFs were properly placed, cabinet temperature of ILR and DFs was maintained in normal range in all the three (100%) CHCs. Record of power failure, records of defrosting/cleaning was maintained in temperature log book and cold chain handlers had knowledge of shake test in only 33.3% CHC.Conclusions: Proper vaccine storage and management of cold chain system is essential for immunization. In order to improve quality of immunization services there is a need of space, temperature monitoring and regular defrosting with record keeping and regular training of cold chain handlers to keep their knowledge and skills updated. Monitoring and supervision of cold chain points by DIO should be on regular basis.

SVEP1, PKHD1, and P53 expression in primary liver cancer and its clinical significance / 中国肿瘤临床

Objective: To detect the expression of SVEP1, PKHD1 and P53 in primary liver cancer tissues by immunohistochemistry for predicting the recurrence of liver cancer. Methods: The clinical data of 103 patients with primary liver cancer who underwent surgical resection at Tianjin Medical University Cancer Institute and Hospital were gathered from January 2013 to January 2014 and analyzed retrospectively. Expression values of three different proteins were used to develop separate immunohistochemical scores for the prog-nosis of recurrence in patients. The patients were classified into either a high-risk or a low-risk group based on their immunohisto-chemical scores through ROC curve analysis. The difference in recurrence ratio between the two groups was then compared using the common research index of disease-free survival (DFS). Results: The median age of the total patients was 55 years (range 21-88 years), the median AFP level was 70.6 (range 1.03-718840.0) μg/L, the median CA19-9 level was 22.89 (range 0.6-1000.0) kU/L, and the medi-an tumor size was 4.5 (1.0-27.0) cm. The expression levels of SVEP1, PKHD1, and P53 in primary liver tumors were detected by immu-nohistochemistry and assigned separate immunohistochemical scores. The areas under the ROC curves of the immunohistochemical scores of SVEP1, PKHD1, and P53 were 0.861, 0.829, and 0.716, respectively. The critical values of SVEP1, PKHD1, and P53 were 4, 4, and 1 point, respectively (P<0.001). The three-year DFS rates among the SVEP1 high-risk (expression≤4 points) and low-risk groups (expression>4 points) were 4.1% and 51.7%, respectively. Similarly, the three-year survival rates among the PKHD1 high-risk (expres-sion≤4 points) and low-risk groups (expression>4 points) were 5.3% and 51.9%, respectively. The three-year DFS rates among the P53 high-risk (expression>1 point) and the low-risk group (expression≤1 point) were 6.3% and 27.3%, respectively. The survival differenc-es between all the pairs were statistically significant (P<0.001,<0.001, and 0.003 respectively). When PKHD1 was used in combination with SVEP1, the ROC curve had an area of 0.897 (P<0.001) with a sensitivity of 76.5% and a specificity of 94.4%. Conclusions: The accu-racy of P53 data for predicting primary liver cancer recurrence is insufficient and therefore it is not recommended for use. SVEP1 and PKHD1 data achieve sufficient accuracy for predicting the recurrence of primary liver cancer. Since SVEP1 data impart a higher specifici-ty and PKHD1 data impart a higher sensitivity to the prognosis scores, the combined use of the two markers is better than being used individually.

Anticuerpos anti-DFS70: un nuevo autoanticuerpo útil en la exclusión de patologías autoinmunes / Anti-DFS70 antibodies: A new useful antibody in the exclusion of auto-immune diseases

RESUMEN Los anticuerpos anti-DFS70 (Dense Fine Speckle, peso molecular de 70 kd) son un subgrupo de anticuerpos antinucleares (ANA) de tipo natural, los cuales se manifiestan por un patrón moteado denso fino (DFS) por inmunofluorescencia indirecta. Este se caracteriza por la fluorescencia granular distribuida irregularmente en la interface de los núcleos y de la cromatina. Inicialmente, este anticuerpo fue descrito en pacientes con cistitis intersticial, dermatitis atópica y algunas neoplasias como el cáncer de próstata. Se ha encontrado que sus antígenos actúan directamente contra co-activadores de la transcripción nuclear (LEDGF/p75), codificada por el gen PSP1 y localizado en la región C terminal entre los a.a. 349 y 435. Adicionalmente, se documenta asociación con algunas funciones fisiológicas como la protección contra la apoptosis inducida por estrés, promover la supervivencia de las células epiteliales del cristalino y actuar como cofactor de replicación del virus VIH a través de su interacción con la integrasa viral. En el campo de la autoinmunidad se ha evidenciado recientemente la importancia de este anticuerpo como marcador biológico útil en la discriminación de personas con ANA positivos que no evolucionan a enfermedad autoinmune sistémica (EAI). Lo anterior se ha basado en la observación de que estos anticuerpos son más frecuentes en individuos sanos que en los pacientes con EAI y que los individuos sanos con anti-DFS70 positivo no desarrollaron EAI después de un seguimiento clínico por 4 arios o más. Este artículo revisa la descripción de los anti-DFS70 y su utilidad en la práctica clínica.

ABSTRACT Anti-DFS70 antibodies (Dense Fine Speckled, 70 kd molecular weight) are a sub-group of anti-nuclear antibodies (ANA) that show a fine dense speckled pattern (DFS) by indirect immunofluorescence. This pattern is also recognized by irregularly distributed granular fluorescence at the interface of nuclei and chromatin. This antibody was initially described in patients with interstitial cystitis, atopic dermatitis, and malignancy, such as prostate cancer. These antigens have been found to act directly against co-activators of nuclear transcription (LEDGF/p75) encoded by the PSP1 gene and located in the C-terminal region between the a.a. 349 and 435. Additionally, associations with some physiological functions have been described, such as protection against stress-induced apoptosis, the survival of lens epithelial cells, and acting as a cofactor of HIV replication through its interaction with viral integrase. As regards autoimmunity, recent evidence has also shown the importance of this antibody as a useful biological marker in the discrimination of individuals with positive ANA that do not progress to systemic autoimmune disease (SID). This is based on the observation that these antibodies are more common in healthy individuals than in patients with SID, and that healthy individuals with positive anti-DFS70 did not develop SIDs after a clinical follow-up of four years or more. This article reviews the description of anti-DFS70 and its usefulness in clinical practice.

High expression of MICA/B prolongs disease-free survival in patients with HER2positive breast cancer / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To investigate the relationship between expression of MICA/B (MHC class I chain-related proteinA/B) and disease-free survival (DFS) of patients with HER2+(human epidermal growth factor receptor 2) breast cancer tissue. Methods: Twenty six cases of corresponding para-cancerous tissue and 100 cases of HER2+ breast cancer tissue that preserved in wax at Zhengzhou People’ s Hospital Affiliated to Southern Medical University from January 2009 to June 2010 were collected for this study. Expression of MICA/ B in these tissue samples was detected by immunohistochemistry; and the relationship between MICA/B expression with clinicopathologic features as well as DFS was analyzed with Kaplan-Meier survival curve. Results: The expression of MICA/B in adjacent paracancerous tissues was negative (0/26), however, it was highly positive in cancer tissues (92/100), and the percentage with high expression was 65%(65/100), the difference was significant (P<0.05). High MICA/B expression rate in stage I was significantly higher than that in stage Ⅱ-Ⅲ (77.55% vs 52.94%， P<0.05), and the high expression rate in stage T1 was also significantly higher than that in stage T2-T4 (75.00% vs 52.27%， P<0.05). High MICA/B expression rate in ER+, PR+ group (with positive number≥1%) was significantly lower than that in ER- , PR-group (ER： 52.38% vs 74.14%，PR： 51.35% vs 73.02%， all P<0.05). MICA/B expression was correlated with clinical stages, the expression of ER, PR and tumor size (all P<0.05), but not associated with menopausal status, histological grade and lymph node metastasis (all P>0.05). Over-expression of MICA/B was closely associated with much better 6-year DFS rate in patients no matter with or without targeted therapy (the targeted group: 90.6% vs 72.2%; the untargeted group: 78.4% vs 58.8%, all P<0.05). Conclusion: Over-expression of MICA/B in HER2+ breast cancer tissue is closely related to DFS, which may be served as a potential prognosis indicator for patients with HER2+ breast cancer.

Sarcoma de mediastino. Serie de casos y revisión de la literatura. Departamento de Oncología Torácica. Instituto Nacional de Cancerología. INCan / Mediastinal sarcoma. Literature review and a series of cases. Department of Thoracic Oncology. National Institute of Cancerology. INCan

Resumen El sarcoma de mediastino es un raro tumor que representa menos del 10% de los tumores del mediastino y alrededor del 1-2% de todas las neoplasias malignas en general. Debe abordarse en centros de referencia, donde se evalué multidisciplinariamente y se tengan opciones de manejo multimodal, infraestructura que permita la resección y reconstrucción quirúrgica mayor y estricto seguimiento, teniendo en cuenta la alta recurrencia local, cercana al 30%. Exponemos una serie de casos presentados a lo largo de 20 años de experiencia con la participación de varios departamentos, ajustándonos a la definición y manejo con la literatura actual.

Abstract Mediastinum sarcoma is a rare tumor that represents less than 10% of mediastinal tumors and about 1-2% of all malignancies in general. It should be approached in reference centers with multidisciplinary evaluation and multimodal management options, with an infrastructure that allows surgical resection and reconstruction and strict follow-up, taking into account the high local recurrence that is close to 30%. Therefore, we present a series of cases in 20 years of experience with the participation of several departments and adjusting the definition and management with the current literature.

Anti DFS70 ¿Un auto anticuerpo marcador de salud?: Revisión / DFS70 Antibody. A health marker?: Review

Se analiza el posible rol de los anti-DFS70 como marcadores biológicos útiles, para excluir enfermedad reumática autoinmune.

The possible role of anti-DFS70 helpful biomarkers analyzed, to exclude autoimmune rheumatic disease.

Clinical Significance of FLT3 in patients with AML / 现代检验医学杂志

Objective To explore the expression of FLT3 on the cells from acute myeloblastic leukemia (AML)and its clinical signficance.Methods The expression of FLT3 from 80 AML cases was measured by FISH.All cases were indentified by karyotyping,40 cases were normal karyotye,and the other 40 cases were abnormal.Results The FLT3 expression level was different in different AML cases.The expression rate in normal karyotype cases was 5.0%,but in abnormal cases 30.7%,in refractory relapse cases 43.3%,in continual complete remission cases 4.5%.The patients’DFS (Disease-Free survival)and OS (overall survival)without FLT3 expression were 65% and 86% in 24 months’following investigation,but the patients’ DFS and OS with FLT3 expression were 20% and 40% respectively.The difference was distinct between them(P<0.05). Conclusion FLT3 can be thought as a new marker for worse prognosis of AML patients,and its expression level is associat-ed with maglignacy-grade.

Review on dental fear and anxiety factors by DFS / 대한구강보건학회지

OBJECTIVES: The study on dental fear has increased recently. Studies found that people with high dental fear and or anxiety were less likely to visit dentists. The aim of this study is to review the trend of study on dental fear and to analyse the major factors related to dental fear. METHODS: Seventy four papers listed in Korea Citation Index and SCI(E) were assessed. Quality Assessment and Validity Tool for Correlation Studies (QAVTCS) and Dental Fear Study (DFS) were used in this study. SPSS 12.0 was employed to analyse the descriptive statistics, t-test and Multiple Linear Regression (MLR) with stepwise. RESULTS: The total mean score of QAVTCS for international studies was significantly higher than domestic studies (P=.001). The mean scores of item, 'Seeing the anesthetic needle' and 'Feeling the anesthetic needle', were severe level (Means= 3.05, 3.14, severe>3.00). According to the MLR, the powerful predisposing factors (independent variable) on 'Overall fear of dentistry (dependent variable)' were 'Hearing the drill' (P<.01) and 'Having teeth cleaned' (P<.05). CONCLUSIONS: It was concluded that people had high dental fear in direct dental treatment environment such as contact with seeing anesthetic needle and hearing dental drill. Therefore, this study suggests the need to map out specific and multidirectional plan for decreasing dental fear.

Effect of Double Fortified Salt Supplementation on Iodine and Hemoglobin Status of School Children of Rural Vadodara, India.

Iron deficiency along with iodine deficiency affects the developing brains, physical and mental growth of the children. Multiple micronutrient deficiencies co-exists in developing countries at a higher rate due to monotonous diets with low nutrient density. Hence, food fortification has been used as a tool to increase the content of essential micronutrients. Aim Our study was aimed to assess the efficacy of DFS supplementation on iodine and hemoglobin status of the rural school children Methods Interventional study. Rural school children (6-15 yrs) randomly divided into experimental and control group. Experimental were supplemented with double fortified salt (DFS) and controls consumed adequately iodized salt (IS). Pre and post hemoglobin concentration (Hb) and urinary iodine (UI) recorded. Results Mean Hb increased in experimental (+0.42 g/dl) (p<0.001) and decreased in control group (-0.54 g/dl) (p<0.001). The intensity of anemia classification decreased in experimental group and increased in control group. UI increased significantly in both the groups (p<0.001). Hence, DFS is proven to be beneficial compared to IS.

A Standardization Study of Korean DFS (Delivery Fear Scale) in fear of childbirth / 대한산부인과학회지

OBJECTIVE: The study shows that the DFS is a questionnaire that almost effortlessly can be completed within 60-90 seconds during any moment of labor and delivery. The aim of the present study was to test the validity and reliability of the DFS, to identify its factor structure in Korea. METHODS: Review of the medical records from the department of obstetrics and gynecology from January to April 2005, a confirmed 51 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 22 primiparous and 29 multiparous women answered the Delivery Fear Scale (DFS) once during active labor, and the STAI (State-Trait Anxiety Inventory) after delivery. Reliability test to calculate Chronbach alpha and validity test to measure correlation between DFS and STAI was done. Then factor analysis was applied with the method of principal component analysis and varimax rotation. RESULTS: Korean version of DFS proved to be a reliable and valid scale statistically: Cronbach's alpha was 0.7182 in study. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The DFS measures fear during labor and delivery in an effortless and fast away. The development of the Korean version of DFS which is reliable and valid, and consists of three sub-factors may facilitate future research in the field.

Factors Associated with Fear during labor / 대한산부인과학회지

OBJECTIVE: Pregnant women have various fears and expectations regarding the impending birth. Fears can influence the course of the delivery and post-partum period. The DFS (Delivery Fear Scale) measures fear during labor and delivery in an effortless and fast away. The aim of this study were to compare DFS score and parity, maternal age, history of abortion, baby gender during an early stage of active labor (cervix dilatation 3-5 centimeters). METHODS: Review of the medical records from the department of obstetrics and gynecology from January 2004 to December confirmed 151 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 86 primiparous and 65 multiparous women answered the Delivery Fear Scale (DFS) once during active labor. Mann-Whitney test was applied to test possible differences between DFS and variable factors. Difference were considered to be statistically significant at p<0.05. RESULTS: Primiparous women had higher scores on the DFS than multiparous women during active labor. But DFS was not associated with maternal age, history of abortion, baby gender during an early stage of active labor. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The understanding of a fear during labor is to support the woman in labor in a way that decrease fear and the development of the DFS may facilitate future research in the field.

Assessment of Dietary Intake of Preschool Children in Busan : Assessment Based on Food Group Intake / 대한지역사회영양학회지

To assess diet quality by food group intake and to investigate the interrelationship of age, dietary diversity score(DDS), dietary variety score(DVS), dietary frequency score(DFS), food group intake and nutrient intake with food group intake, a dietary survey was conducted with 176 preschool children aged 1 to 6 in Busan using a 24-hr recall method. Food group intake was assessed by food number consumed and intake frequency by six food groups(grain, meat, vegetable, fruit, dairy, sweets group). The mean food numbers consumed and intake frequencies by six feed group were 3.1 and 4.0 in the grain group, 3.6 and 4.0 in the meat group, 3.5 and 4.1 in the vegetable group, 1.0 and 1.1 in the fruit group, 1.3 and 1.5 in the dairy group, 1.4 and 1.4 in the sweets group respectively. As age increased, the intake frequency of the grain group(p<0.05) increased but that of the dairy group(p<0.05) decreased significantly. The DVS and DFS didn't show significant correlations with intake frequency of the dairy group. The grain group intake had significant positive correlations with intakes of the meat, vegetable, and fruit groups. The vegetable group intake had signigicant positive correlations with intakes of the grain and meat groups. The dairy group intake had significant positive correlation with sweets group intake but negative correlations with intakes of the grain and vegetable groups. As the intake frequency of the meat group increased, the NAR(nutrient adequacy ratios) of all nutrients and NAR(mean adequacy ratio) increased significantly. NARs of provein iron, vitamin B1, niacin had the highest correlation with the meat group intake and those of protein, calcium, phosphorous, and vitamin B2 had the highest correlation with the dairy group intake. NARs of vitamin A and vitamin C had the highest correlation with intake of the vegetable and fruit groups respectively. Children with food number consumed and intake frequency of above 6 and 4 in the grain group or above 6 and 6 in the meat group or above 4 and 8 on the v......