Implication of FSHB rs10835638 variant in endometriosis in Brazilian women

ABSTRACT Objective The follicle-stimulating hormone subunit beta gene rs10835638 variant (c.-211G>T) may have detrimental effects on fertility and protective effects against endometriosis. A case-control analysis was performed, aiming to investigate the possible relationship between this variant and the development and/or progression of endometriosis. Methods This study included 326 women with endometriosis and 482 controls without endometriosis, both confirmed by inspection of the pelvic cavity during surgery. Genotyping was performed using a TaqMan real-time polymerase chain reaction assay. Genotype and allele frequencies and genetic models were compared between the groups. Results The genotype and allele frequencies of the rs10835638 variant did not differ between women with and those without endometriosis. Subdividing the endometriosis group into fertile and infertile groups did not result in a significant difference in these frequencies. However, the subgroup with minimal/mild endometriosis had a higher frequency of the GT genotype than the Control Group, regardless of fertility. The T allele was significantly more common in women with minimal/mild endometriosis than in the Control Group in the recessive model. Conclusion The T allele is associated with the development of minimal/mild endometriosis in Brazilian women.

Beta-gonadotropina coriónica humana cualitativa, herramienta diagnóstica de rotura prematura de membranas ovulares en Honduras / Qualitative human beta chorionic gonadotropin for the diagnosis of premature rupture of membranes in Honduras

RESUMEN Objetivo : Analizar la beta gonadotropina coriónica humana (β-hCG) cualitativa como método diagnóstico de rotura prematura de membranas ovulares (RPM). Métodos: Estudio de casos y controles, prospectivo, con muestra no probabilística por conveniencia, de 90 mujeres entre 24 y 40 semanas de gestación divididas en dos grupos: grupo de estudio (45 pacientes con diagnóstico clínico de RPM) y grupo control (45 pacientes hospitalizadas sin RPM). Se realizó lavado o aspirado vaginal para determinar cualitativamente la β-hCG en kits comerciales de medición β-hCG con umbral de 25 mUI/mL, así también la prueba en papel de nitrazina. Resultados: La sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo para la prueba de β-hCG-25 fueron 77,8% (IC95%, 63,7 a 87,5), 82,2% (IC95%, 68,7 a 90,7), 81,4% y 78,7%, respectivamente. La precisión diagnóstica fue de 80,0% (0,6 índice kappa Landis & Koch) versus 75,6% para la pH-metría con nitrazina. Conclusiones: La prueba cualitativa de β-hCG mostró un valor diagnóstico representativo y puede corroborar el diagnóstico temprano de RPM, recomendándola por ser una prueba simple, rápida, accesible y de bajo costo.

ABSTRACT Objective : To analyze qualitative human beta chorionic gonadotropin (β-hCG) as a diagnostic method for premature rupture of membranes (PROM). Methods : Prospective case-control study, with a non-probabilistic sample by convenience, of 90 women between 24 and 40 weeks of gestation divided into two groups: study group (45 patients with clinical diagnosis of PROM) and control group (45 patients hospitalized without PROM). Vaginal lavage or aspirate was performed to qualitatively determine β-hCG in commercial β-hCG measurement kits with threshold of 25 mUI/mL as well as nitrazine paper test. Results : The sensitivity, specificity, positive predictive value, and negative predictive value for the β-hCG-25 test were 77.8% (95% CI, 63.7-87.5), 82.2% (95% CI, 68.7-90.7), 81.4%, and 78.7%, respectively. Diagnostic accuracy was 80.0% (0.6 Landis & Koch kappa index) versus 75.6% for nitrazine pH-metry. Conclusions : The qualitative β-hCG test showed a representative diagnostic value and can corroborate the early diagnosis of PROM, recommending it as a simple, rapid, accessible and low-cost test.

Efficacy of laparoscopic uterine curettage combined with uterine artery embolization in the treatment of cesarean scar pregnancy after type Ⅲ cesarean delivery / 中国基层医药

Objective:To investigate the efficacy of laparoscopic uterine curettage combined with uterine artery embolization in the treatment of cesarean scar pregnancy (CSP) after type Ⅲ cesarean delivery.Methods:Sixty patients with type Ⅲ CSP who received treatment in Jinxiang Hospital Affiliated to Jining Medical University from January 2017 to October 2019 were included in this study. They were randomly assigned to undergo either laparoscopic uterine curettage alone (control group, n = 30) or laparoscopic uterine curettage combined with uterine artery embolization (observation group, n = 30). The amount of intraoperative blood loss, length of hospital stay, surgical cure rate, time to beta human chorionic gonadotropin (β-HCG) value returning to normal level, and the incidence of postoperative complications were compared. Results:The amount of intraoperative blood loss in the observation group was significantly less than that in the control group [(42.36 ± 15.03) mL vs. (119.52 ± 21.84) mL, t = 15.941, P < 0.05]. Length of hospital stay [(6.51 ± 2.21) days vs. (19.25 ± 3.43) days] and the time to β-HCG value returning to normal level [(16.25 ± 5.02) days vs. (28.02 ± 9.38) days] in the observation group were significantly shorter than those in the control group ( t = 17.102, 6.060, both P < 0.05). There was no significant difference in surgical cure rate between the observation and control groups [96.67% (29/30) vs. 90.00% (27/30), χ2 = 0.268, P > 0.05]. There were no significant differences in the incidence of postoperative fever [63.33% (19/30) vs. 56.67% (17/30)], pain [56.67% (17/30) vs. 46.67% (14/30)], infection [6.67% (2/30) vs. 10.00% (3/30)] and vaginal bleeding [6.67% (2/30) vs. 13.33% (4/30)] between the observation and control groups ( χ2 = 0.278, 0.601, 0.000, 0.185, all P > 0.05). Conclusion:Laparoscopic uterine curettage combined with uterine artery embolization for the treatment of type Ⅲ CSP is superior to laparoscopic uterine curettage alone in terms of intraoperative blood loss, hospital stay, surgical cure rate, time to β-HCG value returning to normal level and safety. Therefore, the combined method is worthy of clinical application.

A recurrent mutation in tshb gene underlying central congenital hypothyroidism undetectable in neonatal screening / Uma mutação recorrente no gene tshb resultando em hipotireoidismo congênito central não detectável na triagem neonatal

ABSTRACT Objective: To describe the case of a patient with central congenital hypothyroidism (CCH) due to a recurrent mutation in the TSHB gene, as well as to conduct a genetic study of his family. Case description: It is presented a case report of a 5-month-old boy with a delayed diagnosis of isolated CCH in whom the molecular analysis was performed 12 years later and detected a recurrent mutation (c.373delT) in TSHB gene. The parents and sister were carriers of the mutant allele. Comments: The c.373delT mutation has previously been reported in patients from Brazil, Germany, Belgium, United States, Switzerland, Argentina, France, Portugal, United Kingdom and Ireland. In summary, our case and other ones reported in the literature support the theory that this mutation may be a common cause of isolated TSH deficiency. Isolated TSH deficiency is not detected by routine TSH-based neonatal screening, representing a clinical challenge. Therefore, when possible, molecular genetic study is indicated. Identification of affected and carriers allows the diagnosis, treatment and adequate genetic counseling.

RESUMO Objetivo: Descrever o caso de um paciente com hipotireoidismo congênito central (HCC) por conta de uma mutação recorrente no gene TSHB, bem como realizar um estudo genético de sua família. Descrição do caso: Relato de caso de um menino de 5 meses de idade com diagnóstico tardio de HCC isolado, em quem a análise molecular foi realizada 12 anos depois e detectou uma mutação recorrente (c.373delT) no gene TSHB. Os pais e a irmã eram portadores do alelo mutante. Comentários: A mutação c.373delT já foi relatada em pacientes do Brasil, da Alemanha, da Bélgica, dos Estados Uinidos, da Suíça, da Argentina, da França, de Portugal, do Reino Unido e da Irlanda. Em resumo, nosso caso e outros relatados na literatura reforçam a teoria de que essa mutação pode ser uma causa comum de deficiência isolada de TSH. A deficiência isolada de TSH não é detectada na triagem neonatal com base na dosagem de TSH, representando um desafio clínico. Portanto, quando possível, o estudo genético molecular é indicado. A identificação dos afetados e dos portadores permite o diagnóstico, o tratamento e o aconselhamento genético adequado.

Prokaryotic expression of ATP5B and preparation and identification of its monoclonal antibody / 吉林大学学报(医学版)

Objective: To construct and identify the monoclonal antibody of ATP synthase beta subunit (ATP5B) with high purity, and to lay foundation for further study. Methods: The ATP5B gene was amplified by PCR and cloned into the pET28a vector and transformed into K. coli BL21 (DE3). The protein expression was induced by IPTG and then the fusion protein was purified by nickel affinity chromatography column. The protein purity was detected by SDS-polyacrylamide gel electrophoresis (SDS-PAGE). Three female Balb/C mice were immunized with purified fusion protein and the tail vein blood was taken to detect the titer of ATP5B antibody by indirect enzyme-linked immunosorbent assay (ELISA). The spleen cells from the immunized mice with the highest serum titer were mixed with the SP2/0 cells to establish the hybridoma cells and the fused cells were screened by indirect ELISA and monoclonally cultured. Karyotype analysis were performed in the positive cells. The hybridoma cells were intraperitoneally injected into 12 weeks old BALB/C mice to estabilish the ascites models. The titer of ascites was detected by indirect ELISA. The purity of tlie antibody was detected by SDS-PAGE. The antibody subtype was detected by ELISA. Results: After PCR amplification, a specific band of 1 455 bp was obtained, and the pET28a empty vector was ligated to obtain a recombinant pET28a/ATP5B vector. The target protein was expressed in the IPTG-induced bacteria solution; the SDS-PAGE results showed that the protein band was found at 51 000. The indirect ELISA results showed that the serum titer of the venous blood of immunized mice was up to 1: 64 000. In karyotype analysis, the total number of chromosomes in hybridoma cells was about the sum of myeloma cells and normal mouse spleen cells. The mouse ascites was prepared with the hybridoma cell line, and the highest titer of tlie antibody was 1 5 240 000. The subtype of the monoclonal antibody produced by the hybridoma cells was IgGl. Conclusion: The monoclonal antibody against ATP5B protein is successfully prepared by cloning, expressing and purifying the recombinant protein.

Prokaryotic expression of ATP5B and preparation and identification of its monoclonal antibody / 吉林大学学报(医学版)

Objective:To construct and identify the monoclonal antibody of ATP synthase beta subunit (ATP5B) with high purity, and to lay foundation for further study.Methods:The ATP5Bgene was amplified by PCR and cloned into the pET28avector and transformed into E.coli BL21 (DE3) .The protein expression was induced by IPTG and then the fusion protein was purified by nickel affinity chromatography column.The protein purity was detected by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) .Three female Balb/C mice were immunized with purified fusion protein and the tail vein blood was taken to detect the titer of ATP5Bantibody by indirect enzyme-linked immunosorbent assay (ELISA) .The spleen cells from the immunized mice with the highest serum titer were mixed with the SP2/0cells to establish the hybridoma cells and the fused cells were screened by indirect ELISA and monoclonally cultured.Karyotype analysis were performed in the positive cells.The hybridoma cells were intraperitoneally injected into 12weeks old BALB/C mice to estabilish the ascites models.The titer of ascites was detected by indirect ELISA.The purity of the antibody was detected by SDS-PAGE.The antibody subtype was detected by ELISA.Results:After PCR amplification, a specific band of 1 455bp was obtained, and the pET28aempty vector was ligated to obtain a recombinant pET28a/ATP5Bvector.The target protein was expressed in the IPTG-induced bacteria solution;the SDS-PAGE results showed that the protein band was found at51 000.The indirect ELISA results showed that the serum titer of the venous blood of immunized mice was up to1:64 000.In karyotype analysis, the total number of chromosomes in hybridoma cells was about the sum of myeloma cells and normal mouse spleen cells.The mouse ascites was prepared with the hybridoma cell line, and the highest titer of the antibody was 1:240 000.The subtype of the monoclonal antibody produced by the hybridoma cells was IgG1.Conclusion:The monoclonal antibody against ATP5Bprotein is successfully prepared by cloning, expressing and purifying the recombinant protein.

Factores de riesgo, diagnóstico histológico y concentraciones de beta-hCG en pacientes con mola hidatiforme / Risk factors, histological diagnosis and beta-hCG concentrations in patients with hydatidiform mole

Resumen Introducción: La mola hidatiforme es la forma más común de enfermedad trofoblástica gestacional. La cuantificación de beta-hCG sérica tiene importante valor en su diagnóstico y pronóstico, no obstante en Colombia no se cuenta con referencias de sus niveles según el tipo de mola o factores de riesgo. Objetivo: Estudiar el comportamiento de los valores de beta-hCG según el tipo de mola y los factores de riesgo. Materiales y Métodos: Se estudiaron 74 casos con diagnóstico de mola hidatiforme en el departamento de patología de la Universidad Industrial de Santander entre los años 2005 y 2014. Se registró a partir de los datos proporcionados por la historia clínica: hábito de fumar, hemoclasificación, indicación de régimen EMA-CO, antecedentes sociodemográficos y ginecoobstétricos y la concentración de beta-hCG previa al tratamiento evacuador. Resultados: 63 casos presentaron mediciones válidas de beta-hCG. En el análisis se utilizaron pruebas no paramétricas con un nivel de significancia del 10%. La mediana de beta-hCG para mola completa y parcial fue 270 852 UI/L y 40 379 UI/L respectivamente. Hubo una diferencia significativa para los valores de beta-hCG entre grupos de mola (p<0,0001). Para el diagnóstico de mola completa un punto de corte de 170 000 U/L presentó una sensibilidad del 91,5% y una especificidad del 75%. La indicación de EMA-CO presentó una asociación significativa con los valores de beta-hCG (p=0,066); no alcanzaron significancia las asociaciones con el tabaquismo (p=0,118) y la multiparidad (p=0,111). Conclusión: La cuantificación de beta-hCG ayuda a clasificar el tipo de mola aunque su rendimiento diagnóstico es modesto. MÉD.UIS. 2018;31(1):39-46.

Abstract Introduction: Hydatidiform mole is the most common form of gestational trophoblastic disease. The quantification of serum beta-hCG has important value in its diagnosis and prognosis, however in Colombia there are no references of its values according to the type of mole or risk factors. Objective: To study the behavior of beta-hCG values according to the type of mole and the risk factors. Materials and Methods: 74 cases with diagnosis of hydatidiform mole were studied in the pathology department of the Industrial University of Santander between 2005 and 2014. It was recorded from the data provided by the clinical history: smoking habit, blood sample, indication of the EMA-CO regimen, sociodemographic and gyneco-obstetric antecedents and the beta-hCG concentration prior to the evacuation treatment. Results: 63 cases presented valid measurements of beta-hCG. In the analysis nonparametric tests with a level of significance of 10% were used. The median beta-hCG for complete and partial mole was 270 852 IU / L and 40 379 IU / L respectively. There was a significant difference for beta-hCG values between mola groups (p <0.0001). For the diagnosis of complete mole, a cut-off point of 170,000 U / L showed a sensitivity of 91.5% and a specificity of 75%. The EMA-CO indication showed a significant association with beta-hCG values (p = 0.066); associations with smoking (p = 0.118) and multiparity (p = 0.111) were not significant. Conclusion: The quantification of beta-hCG helps to classify the type of mole although its diagnostic performance is modest. MÉD.UIS. 2018;31(1):39-46.

Patterns of rpoC Mutations in Drug-Resistant Mycobacterium tuberculosis Isolated from Patients in South Korea / 결핵및호흡기질환

BACKGROUND: Rifampicin (RFP) is one of the principal first-line drugs used in combination chemotherapies against Mycobacterium tuberculosis, and its use has greatly shortened the duration of chemotherapy for the successful treatment of drug-susceptible tuberculosis. Compensatory mutations have been identified in rpoC that restore the fitness of RFP-resistant M. tuberculosis strains with mutations in rpoB. To investigate rpoC mutation patterns, we analyzed 93 clinical M. tuberculosis isolates from patients in South Korea. METHODS: Drug-resistant mycobacterial isolates were cultured to determine their susceptibility to anti-tubercular agents. Mutations in rpoC were identified by sequencing and compared with the relevant wild-type DNA sequence. RESULTS: In total, 93 M. tuberculosis clinical isolates were successfully cultured and tested for drug susceptibilities. They included 75 drug-resistant tuberculosis species, of which 66 were RFP-resistant strains. rpoC mutations were found in 24 of the 66 RFP-resistant isolates (36.4%). Fifteen different types of mutations, including single mutations (22/24, 91.7%) and multiple mutations (2/24, 8.3%), were identified, and 12 of these mutations are reported for the first time in this study. The most frequent mutation involved a substitution at codon 452 (nt 1356) resulting in amino acid change F452L. CONCLUSION: Fifteen different types of mutations were identified and were predominantly single-nucleotide substitutions (91.7%). Mutations were found only in dual isoniazid- and RFP-resistant isolates of M. tuberculosis. No mutations were identified in any of the drug-susceptible strains.

Correlation of the single nucleotide polymorphisms rs34349826 and rs6521 of the LHB gene with male infertility in Chinese men / 中华男科学杂志

<p><b>Objective</b>To study the relationship of the single nucleotide polymorphisms (SNP) rs34349826 (c.104 A>G) and rs6521 (c.114 C>G) of the luteinizing hormone beta-subunit (LHB) gene with male infertility in Chinese men.</p><p><b>METHODS</b>This case-control study included 405 males with primary infertility (the infertility group) and 424 normal fertile men (the control group), the former again divided into subgroups of oligospermia, severe oligozoospermia and azoospermia according to the sperm concentration. Clinical data were collected from all the subjects and genomic DNA obtained from their peripheral blood for genotyping rs34349826 and rs6521 of the LHB gene by Sequence MassArray. We analyzed the correlation of male infertility with the SNPs of the two loci using the logistic regression model as well as its association with their haplotype combination with the SHEsis online software.</p><p><b>RESULTS</b>There were statistically significant differences between the control and infertility groups in the semen volume (［3.51 ± 1.36］ vs ［3.74 ± 1.71］ ml, P <0.05), sperm concentration (［79.21 ± 61.60］ vs ［27.37 ± 30.80］ ×10⁶/ml, P <0.01), percentage of progressively motile sperm (［39.40 ± 9.64］ % vs ［11.90 ± 14.72］ %, P <0.01), and levels of serum luteinizing hormone (LH) (［3.29 ± 1.39］ vs ［6.25 ± 4.83］ IU/L, P <0.01) and follicle-stimulating hormone (FSH) (［4.56 ± 2.31］ vs ［15.64 ± 17.03］ IU/L, P <0.01). Logistic regression analysis revealed no correlation between male infertility and the genotypes of the rs34349826 and rs6521 loci of the LHB gene, and similar results were found in the subgroups of the infertile males. SHEsis analysis on the haplotypes of the rs34349826 and rs6521 loci showed the GG genotype combination to be a protective factor against male infertility.</p><p><b>CONCLUSIONS</b>The rs34349826 and rs6521 loci of the LHB gene were not related to male infertility, which can be further confirmed by larger-sample studies. The GG genotype combination is a protective factor against male infertility.</p>

Serum β-hCG concentration is a predictive factor for successful early medical abortion with vaginal misoprostol within 24 hours

OBJECTIVE: To evaluate the predictive factors associated with the success of medical abortion by misoprostol monotherapy within 24 hours in the first trimester of pregnancy. METHODS: The records of 228 women with miscarriage up to 11 weeks of gestational age who underwent medical abortion by intravaginal misoprostol monotherapy were reviewed. Success of abortion was defined as complete expulsion of the conceptus without the need for surgical intervention. Outcomes of interest were success of abortion within 24 hours following administration of misoprostol. RESULTS: Among 222 women who continued the process of medical abortion for 24 hours, 209 (94.1%) had a successfully completed abortion. Multivariate logistic regression showed that serum β-human chorionic gonadotropin (β-hCG) above 40,000 mIU/mL is significantly associated with failed medical abortion within 24 hours (odds ratio [OR], 7.13; 95% confidence interval [CI], 1.60–37.32; P=0.011). The area under the receiver operating characteristic curve of β-hCG level associated with successful abortion within 24 hours was 0.705 (95% CI, 0.63–0.77; P=0.007). Previous vaginal delivery seems to be significantly associated with successful abortion within 24 hours on univariate analysis (P=0.037), but the association was lost in multivariate analysis. CONCLUSION: Misoprostol monotherapy has a high success rate for first trimester abortion. Women with serum β-hCG less than 40,000 mIU/mL are likely to achieve a successful abortion within 24 hours after intravaginal administration of misoprostol.

Preliminary identification of the outer membrane protein H receptors of avian Pasteurella multocida / 中国人兽共患病学报

To identify the receptors for the outer membrane protein H (OmpH) of avian P.multocida,the membrane proteins of chicken embryo fibroblast (CEF) cells were separated by SDS-PAGE and analyzed by Ligand blot.The OmpH-binding protein was identified by MALDI-TOF mass spectrometry,and its distribution in the membrane proteins of different host esophageal mucosal cells was detected by Ligand blot,ELISA and immunofluorescence microscopy,respectively.Ligand blot analysis showed that a 49-kDa membrane protein of CEF cells bound to recombinant OmpH,and MALDI-TOF spectral results demonstrated that the OmpH-binding protein was ATP synthase β subunit.In addition,the OmpH receptor was present in the chicken and rabbit mucosal cell membranes,but was not detected in the bovine and swine mucosal cell membranes.The above results indicate that the OmpH receptor may be CEF cell-derived ATP synthase beta subunit.

Clinical study on Jianpi-Gushen decoction combined with vitamin E and human chorionic gonadotropin for the patients with threatened abortion in early pregnancy / 国际中医中药杂志

Objective To evaluate the efficacy of Jianpi-Gushen decoction combined with vitamin E and human chorionic gonadotropin for the patients with threatened abortion in early pregnancy. Methods A total of 154 patients with threatened abortion who met the inclusion criteria were divided into two groups by a random digital table, with 77 patients in each. The control group was treated with intramuscular injection of human chorionic gonadotropin (HCG) combined with vitamin E, while the observation group was treated with Jianpi-Gushen decoction based on the treatment of control group. The levels of serum β-HCG were detected by radioimmunoassay before and after treatment, and the levels of progesterone were detected by electrochemiluminescence assay, and the efficacy was evaluated. Results The total effective rate in the observation group was 90.9% (70/77), and control group was 77.9% (60/77). The difference between two groups was significantly different (χ2=4.936, P=0.026). The serum β-HCG level (22383.41 ± 4387.67 mIU/ml vs. 15728.66 ± 3375.93 mIU/ml, t=5.614) and progesterone level (58.53 ± 18.77 nmol/L vs. 43.45 ± 17.46 nmol/L, t=2.674) in the observation group after treatment were higher than those in the control group (P<0.01). Conclusions The Jianpi-Gushen decoction combined with vitamin E and HCG could increase the levels of serum β-HCG and progesterone and improve the clinical effect.

Vascular endothelial growth factor andβ-human chorionic gonadotropin are associated with trophoblastic invasion into the tubal wall in ectopic pregnancy / 天津医药

Objective To assess the association between the depth of trophoblastic penetration into the tubal wall with serum concentrations of vascular endothelial growth factor (VEGF) and β-human chorionic gonadotropin (β-HCG). Meth-ods Eighty patients with a diagnosis of tubal pregnancy in the ampullary region underwent radical surgical treatment (sal-pingectomy), were included in this study. The serum levels of VEGF andβ-HCG were detected on the day of surgery. The se-rum level of VEGF was measured by ELISA. The serum level ofβ-HCG was quantified with a two-site immunofluorimetric assay based on the direct sandwichtechnique. Histological material was stained with Masson's trichrome to identify muscular fibers. Immunohistochemical staining was used for human placental lactogen (hPL) to identify intermediate trophoblast and determine the depth of trophoblastic invasion into the tubal wall. The ampullary pregnancies were classified histologically ac-cording to the depth of trophoblastic infiltration into the tubal wall. Results The mean serum values of VEGF andβ-HCG were significantly lower in patients with stage I tubal infiltration than those of stageⅡ, and which were significantly lower in patients with stageⅡthan those in stageⅢ(P<0.05). The threshold serum value of VEGF was 308.6 ng/L, the sensitivity was 100.0%and the specificity was 92.6%for stageⅠand stageⅡ. The threshold serum value of VEGF was 431.9 ng/L, the sensitivity was 79.3%and specificity was 79.2%for stageⅡandⅢ. The threshold serum value ofβ-hCG was 2 509.6 IU/L, the sensitivity was 91.7%and specificity was 81.5%for stageⅠand stageⅡ, and levels of 13 142.6 IU/L, 72.4%and 95.8%for stageⅡand stageⅢ. Conclusion The depth of trophoblastic penetration into the tubal wall is associated with maternal serum concentrations of VEGF andβ-HCG, which can be used as the evaluation index for histological staging of trophoblas-tic tissue infiltration.

Report of rpoB mutation in clinically suspected cases of drug resistant leprosy: A study from Eastern India.

Background: The current strategy for leprosy control depends mainly on early case detection and providing the recommended multidrug therapy (MDT) dosage. Understanding the molecular mechanisms of drug resistance to each of these drugs is essential in providing effective treatment and preventing the spread of resistant strains in the community. The progress of molecular biology research provides a very effi cient opportunity for the diagnosis of drug resistance by in vitro method. Aim: We aimed to investigate the point mutations within the rpoB gene region of the Mycobacterium leprae genome, which are responsible for resistance to rifampicin, in order to determine the emergence of drug resistance in leprosy in the Kolkata region of West Bengal. Methods: A total of 50 patients with a relapse of leprosy were enrolled in the study. Skin smears were obtained for estimation of bacillary index and biopsies were obtained in 70% alcohol for extraction of DNA. The extracted DNA was amplifi ed by M. leprae-polymerase chain reaction (PCR) targeting rpoB gene region. Every single nucleotide base in the sequence is aligned to reference sequence and identity gaps were determined by NCBI – BLAST. Later in-silico analysis was done to identify the changes in the translated protein sequences. Results: A mutation at the base pair position 2275405 where G is replaced by C in the M. leprae genome, which corresponds to the coding region of rpoB gene (279 bp – 2275228 to2275506), was observed in two patients. This missense mutation in CAC codon brings about a glutamic acid to histidine change in the amino acid sequence of RNA polymerase beta subunit at the position 442 (Glu442His), a region specifi c for rifampicin interaction, which might be responsible for unresponsiveness to rifampicin by manifesting a stable bacteriological index in these 2 patients even after completion of 24 months of multibacillary multi-drug therapy (MB-MDT). Limitations: The major limitations of multipleprimer PCR amplifi cation refractory mutation system (MARS) assay is that it capable of detecting mutation at codon 425 and cannot distinguish any silent amino acid changes. Conclusion: The study indicates the existence of rifampicin drug resistance in Eastern India.

Skeletal Muscle Metastasis and Elevated beta-HCG Level Secondary to Tongue Cancer: a Case Report and Review of Literature / 대한내과학회지

Metastases to skeletal muscle and paraneoplastic syndromes involving beta-human chorionic gonadotropin (HCG) production are an extremely rare manifestation of head and neck squamous cell carcinoma. We report a patient with a beta-HCG-secreting squamous cell carcinoma of the tongue with diffuse metastases involving skeletal muscle. A 47 year old female, who was being treated heavily with palliative chemotherapy for metastatic tongue cancer, was admitted with a palpable thigh mass and pain. A magnetic resonance image showed an intramuscular metastasis in the thigh. Ultrasound-guided biopsy of the thigh mass confirmed metastatic squamous cell carcinoma. She was scheduled for enrollment into a clinical trial; however, a positive serum beta-HCG test was noticed. There was no evidence of pregnancy or a trophoblastic or non-trophoblastic tumor secreting beta-HCG. Finally, she was revealed to have a paraneoplastic syndrome with diffuse metastases and was ultimately referred for palliative care. We review the literature of previously reported cases of an increase of beta-HCG in patients with head and neck cancer.

A Role of Serum-Based Neuronal and Glial Markers as Potential Predictors for Distinguishing Severity and Related Outcomes in Traumatic Brain Injury

OBJECTIVE: Optimal treatment decision and estimation of the prognosis in traumatic brain injury (TBI) is currently based on demographic and clinical predictors. But sometimes, there are limitations in these factors. In this study, we analyzed three central nervous system biomarkers in TBI patients, will discuss the roles and clinical applications of biomarkers in TBI. METHODS: From July on 2013 to August on 2014, a total of 45 patients were included. The serum was obtained at the time of hospital admission, and biomarkers were extracted with centrifugal process. It was analyzed for the level of S-100 beta (S100B), glial fibrillary acidic protein (GFAP), and ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1). RESULTS: This study included 33 males and 12 females with a mean age of 58.5 (19-84) years. TBI patients were classified into two groups. Group A was severe TBI with Glasgow Coma Scale (GCS) score 3-5 and Group B was mild TBI with GCS score 13-15. The median serum concentration of S100B, GFAP, and UCH-L1 in severe TBI were raised 5.1 fold, 5.5 fold, and 439.1 fold compared to mild injury, respectively. The serum levels of these markers correlated significantly with the injury severity and clinical outcome (p<0.001). Increased level of markers was strongly predicted poor outcomes. CONCLUSION: S100B, GFAP, and UCH-L1 serum level of were significantly increased in TBI according to severity and associated clinical outcomes. Biomarkers have potential utility as diagnostic, prognostic, and therapeutic adjuncts in the setting of TBI.

Expression of adverse pregnancy in β-HCG,fβ-HCG doubling rate and progesterone levels / 中国基层医药

Objective To investigate the human chorionic gonadotropin (β-HCG) and its free β-subunit (fβ-HCG) content change,to observe the 48 hours multiplication factor,combined with progesterone value in the diagnosis of adverse pregnancy for clinical diagnosis and treatment of adverse pregnancy to provide guidance.Methods The chemiluminescence technique was used to detect serum β-HCG,fβ-HCG and progesterone levels in early adverse pregnancy.According to pregnancy,the pregnant women were divided into threatened abortion group (65 cases),missed abortion group (43 cases) and ectopic pregnancy group (62 cases),while 60 normal pregnant women were selected as control group.Theβ-HCG,fβ-HCG,progesterone levels and 48 hours multiplication factor were measured.The results combined with the pregnancy outcomes were analyzed.Results The serum β-HCG,fβ-HCG,progesterone levels in the threatened abortion group,missed abortion group and ectopic pregnancy group were (15 385 ± 4 350) IU/L,(77.2 ± 21.3) IU/L,(20.8 ± 6.3) μg/L; (1 584 ± 362) IU/L,(119.3 ± 34.1) IU/L,(6.1 ± 3.7) μg/L; (1 459 ± 493) IU/L,(132.1 ± 35.7) IU/L,(5.7 ± 3.4) μg/L; the β-HCG levels 48 hour doubling rates in three groups were (1.52 ±0.51),(0.21 ±0.26),(0.13 ±0.08) ;threatened abortion group β-HCG and 48 hours multiplication factor,progesterone levels and missed abortion and ectopic pregnancy group were significantly different (t =7.41,5.17,6.89,all P ＜ 0.05) ; there were no significant differences between missed abortion group and ectopic pregnancy group (t =0.851,0.782,0.864,all P ＞ 0.05) ;fβ-HCG in threatened abortion group was average 30mIU/mL lower than the missed abortion group and ectopic pregnancy group,the difference was statistically significant (t =6.18,P ＜ 0.05).With miscarriage success fβ-HCG showed a decreasing trend.Conclusion β-HCG and progesterone combined 48 hours multiphcation ratio values for monitoring miscarriage of important guiding significance for the diagnosis of missed abortion and ectopic pregnancy has important reference value trimester β-HCG 48 hour doubling rate of less than 0.5,abortion increased risk;fβ-HCG data descending indicates miscarriage treatment is effective.

Clinical diagnostic value of serum β-hCG and AFP in mediastinal germ cell tumor / 中华检验医学杂志

Objective To explore the clinical diagnostic value of serum human chorionic gonadotropin beta subunit (β-HCG) and alpha fetoprotein ( AFP) in mediastinal germ cell tumors .Methods A retrospective analysis was conducted on the patients who were definitely diagnosed as mediastinal tumors or mediastinal neoplastic lesions .A total of 133 patients were included for analysis between January 2008 and May 2014, divided into two groups.42 cases of mediastinal germ cell tumor patients were marked as case group while 91 cases of other mediastinal tumor or mediastinal neoplastic lesion patients were marked as control group ( including 31 cases of thymoma , 10 cases of mediastinal neurogenic tumor , 2 cases of intrathoracic goiter , 25 cases of mediastinal cyst , 2 cases of mediastinal lipoma , 11 cases of mediastinal lymphoma and 10 cases of thymic carcinoma ) .AFP was detected by chemiluminescence detection , and -HCG was detected by electrochemical luminescence .K-S test was performed to investigate normality of data , non-normally distributed data were described as Median ( interquartile range ) .Mann-Whitney U test was done for measurement of data between two groups .Logistic regression analysis was performed as multivariate analysis.Receiver operating characteristic curve ( ROC) was used to determine the cut-off values.Results The levels of serum AFP and β-HCG in case group were 13.26 (2.39-48.09) ng/ml and 1.99 (0.10-15.7) IU/L, respectively, significantly higher than those in control group [AFP:2.47 (1.78-3.16) ng/ml,β-HCG:0.10 (0.10-0.55) IU/L].The difference of levels of AFP and β-HCG between the case group and the control group were statistically significant ( P=0.000 ) .There were no significant difference when it comes to β-HCG between the case group and intrathoracic goiter patients in control group .Apart from it, the difference of levels of AFP and β-HCG between the case group and every single control group were statistically significant .Cut-off values of AFP and β-HCG for distinguishing mediastinal germ cell tumors from mediastinal tumors were 5.07 ng/ml and 2.32 IU/L.In this scenario, for AFP and β-HCG, sensitivity were 57.1%and 50%, specificity were 97.8%and 96.7%, accuracy were 54.9%and 46.7%, area under the curve ( AUC ) were 0.773 and 0.755, positive likelihood ratios were 26.00 and 15.17respectively.Parallel experiments contributed to increase the sensitivity to 71.4%. Predictive probability (P) =1/[1+exp ( -0.319AFP-0.253HCG+2.850)] was obtained by logistic regression model.When cut-off value of predictive probability ( P ) was 0.30, specificity, AUC, and positive likelihood ratio were increased to 98.9%, 0.835 and 65.00respectively, negative likelihood ratio was decreased to 0.29, positive predictive value and negative predictive value were increased also (96.8%and 88.2%respectively).Conclusion Serum β-HCG, AFP and predictive probability ( P ) is valuable in the diagnosis of mediastinal germ cell tumor .

Serological prenatal screening results of sIUFD when twin pregnancy / 中华检验医学杂志

Objective To study whether there was significant difference between pregnant women , data and the results of prenatal screening of single intrauterine fetal death ( sIUFD) when twin pregnancy and singleton pregnancy for guiding the clinical prenatal screening and risk consulting .Methods By comparative study, 56 cases of sIUFD when twin pregnancy were recorded from 2011 to 2014 in Ningbo Prenatal Diagnosis Center , all were natural pregnancy , the sistens gestational weeks were less than 14 weeks , and 4 993 natural singleton pregnancy .The pregnant women , data and the results of serological prenatal screening between sIUFD and singleton pregnancy were analyzed by t-test and rank sum test .Separately , the 56 cases of prenatal screening , risk value was calculated according to the twins and singleton , then the difference were analyzed combined with the results of follow-up.Results Pregnant women , data of two groups were analyzed, there were no statistically significant difference between sIUFD and singleton pregnancy .The age of sIUFD and singleton was (27 ±3)year-old and (27 ±3)year-old respectively, t=2.56, P>0.05; the weight of sIUFD and singleton was (55.2 ±10.23 ) kg and (56 ±10.34) kg, t=4.268, P>0.05.The gestational weeks of sIUFD and singleton were (39.21 ±0.78)weeks and (39.1 ±0.91) weeks, t=1.3, P>0.05;the weight of newborn was (3.38 ±0.41) kg and (3.31 ±0.43) kg, t=1.9, P>0.05.The AFP multiple of median (AFPMOM) of sIUFD and singleton was 1.41(0.99,1.83) and 1.02(0.84,1.24), Z=5.337, P0.05;unconjugated estriol multiple of median of sIUFD and singleton was 1(0.79,1.16) and 1.01(0.85,1.21), Z=1.334, P>0.05.Trisomy 21 risk of sIUFD and singleton was 7 750(2 200,28 000) and 5 300(2 000,12 000), Z=2.093, P<0.05, that had significant difference.The 56 cases of prenatal screening risk value was calculated according to the twins and singleton , among whom 42 cases had the same conclusion , 14 cases had the different conclusion .Among them, according to singleton calculation , 3 cases for high risk, according to the twin calculation of high risk for 17 cases,χ2 =12.1, P <0.05.According to follow-up, all newborns were normal.Conclusions For the natural pregnancy , sIUFD when twin pregnancy , if the sistens gestational weeks less than 14 weeks, the risk of prenatal screening results calculated according to singleton will be more reasonable , as for the prenatal screening for twin pregnancy , the method needs further exploration .