Gene and microRNA expression reveals sensitivity to paclitaxel in laryngeal cancer cell line

Paclitaxel is a widely used chemotherapy drug for advanced laryngeal cancer patients. However, the fact that there are 20-40% of advanced laryngeal cancer patients do not response to paclitaxel makes it necessary to figure out potential biomarkers for paclitaxel sensitivity prediction. In this work, Hep2, a laryngeal cancer cell line, untreated or treated with lower dose of paclitaxel for 24 h, was applied to DNA microarray chips for gene and miR expression profile analysis. Expression of eight genes altered significantly following paclitaxel treatment, which was further validated by quantitative real-time PCR. Four up-regulated genes were ID2, BMP4, CCL4 and ACTG2, in which ID2 and BMP4 were implicated to be involved in several drugs sensitivity. While the down-regulated four genes, MAPK4, FASN, INSIG1 and SCD, were mainly linked to the endoplasmic reticulum and fatty acid biosynthesis, these two cell processes that are associated with drug sensitivity by increasing evidences. After paclitaxel treatment, expression of 49 miRs was significantly altered. Within these miRs, the most markedly expression-changed were miR-31-star, miR-1264, miR-3150b-5p and miR-210. While the miRs putatively modulated the mRNA expression of the most significantly expression-altered genes were miR-1264, miR-130a, miR-27b, miR-195, miR-1291, miR-214, miR-1277 and miR-1265, which were obtained by miR target prediction and miRNA target correlation. Collectively, our study might provide potential biomarkers for paclitaxel sensitivity prediction and drug resistance targets in laryngeal cancer patients.     

Serial MRI findings of acute flaccid myelitis during an outbreak of enterovirus D68 infection in Japan

Objecive

To clarify the neuroimaging findings of children with acute flaccid myelitis during an outbreak of EV-D68 infection.

胰十二指肠切除术后迟发性动脉出血的诊治分析

目的探讨胰十二指肠切除术后迟发性动脉出血的诊断和治疗方法。方法回顾性分析我院2004年1月至2012年9月诊治的5例胰十二指肠切除术后迟发性动脉出血患者的资料。结果有3例患者合并高血压病、冠心病,4例患者术后有胰漏、腹腔脓肿等并发症,所有患者均经动脉造影确诊并经栓塞止血治愈。结论高血压病、冠状动脉粥样硬化、术后并发胰漏、腹腔脓肿是发生胰十二指肠切除术后迟发性动脉出血的危险因素,经动脉血管造影和栓塞对诊断和治疗有极大的帮助。     

胃癌腹腔镜手术近远期疗效的循证医学评价

治疗胃癌的腹腔镜胃切除手术(laparoscopic gastrectomy,LG)在过去的20年中运用范围日益广泛。相关的循证医学结果显示,在近期疗效方面,LG 已达到不低于开腹胃切除手术(open gastrectomy,OG)的肿瘤临床治疗效果,且具有微创等优势。在远期疗效方面,LG 与 OG 治疗早期胃癌相近的疗效已获得了充足的循证医学证据,LG 已成为早期胃癌可选的标准治疗方法之一。虽然不少研究显示 LG 治疗进展期胃癌亦能取得 OG 同样的远期疗效,但仍缺乏多中心的前瞻性随机对照研究结果来评价腹腔镜手术的优劣。外科医师只有严格选择合适病例,手术中严格遵循恶性肿瘤手术的根治原则,才能使腹腔镜胃癌根治术在取得微创优势的基础上具有与开腹手术相当的疗效。     

Imaging of Dermatofibrosarcoma Protuberans of Breast

Abstract: Dermatofibrosarcoma protuberans (DFSP) is a rare superficial soft tissue malignancy. We report a 45‐year‐old woman diagnosed with DFSP involving the breast. Ultrasound of DFSP revealed a heteroechogenetic breast mass, which showed normal adjacent dermis. Mammography disclosed a high‐density mass without microcalcification. MRI showed an enhancing lobulated lesion with small area of cystic change and hemorrhage. The patient underwent excision biopsy and pathology revealed DFSP of the breast. DFSP involving the breast is rare and preoperative diagnosis by imaging could be a challenge for clinicians. A solitary mixed echogenicity and ill‐defined soft tissue with no microcalcification located in the subdermal region could indicate the presence of DFSP.     

Brief informant screening test for mild cognitive impairment and early Alzheimer's disease

BACKGROUND/AIMS: Recent research has attempted combinations of instruments to improve screening accuracy for mild cognitive impairment (MCI) and early Alzheimer's disease (AD). We compared Mini-Mental State Examination (MMSE), Immediate and Delayed Recall (Logical Memory I and II; LM-I and LM-II, respectively), a single-item informant report of memory problem (IRMP), and a four-item Instrumental Activities of Daily Living (4IADL) scale, and combinations of these tests. METHOD: The tests were administered together with Clinical Dementia Rating (CDR) to subjects who were cognitively intact (CDR = 0, n = 88), and with diagnoses of MCI (CDR = 0.5, n = 37) and early AD (CDR = 1-2, n = 19). RESULTS: Screening accuracy (receiver operating characteristic area under curve, AUC) for identifying MCI or MCI-AD was lowest for MMSE (AUC 67.6% for MCI or 77.9% for MCI-AD), and better for IRMP (79.5 or 83.2%), 4IADL (76.9 or 84.7%), LM-I (81.2 or 87.1%) and LM-II (86.1 or 90.8%). Combining IRMP, 4IADL and LM-II was most accurate (AUC 91.7% for MCI or 94.5% for MCI-AD); sensitivity: 86.5 or 89.3%; specificity: 86.4 or 88.6%. However, combining IRMP and 4IADL gave nearly as good accuracy (AUC 87.2 or 91.6%); sensitivity: 86.5 or 85.7%; specificity: 79.5 or 85.2%. CONCLUSION: A brief instrument combining an IRMP and 4IADL items is potentially useful in screening for MCI and early AD.     

Removal of oral secretion prior to position change can reduce the incidence of ventilator‐associated pneumonia for adult ICU patients: a clinical controlled trial study

Aim. The purpose of this study was to explore the effect of oral secretion on aspiration and reducing ventilator‐associated pneumonia. Background. Ventilator‐associated pneumonia is a serious hospital‐acquired infection with reported incidence rate of 12·2% and mortality rate of 29·3%. Oral secretion is purported as a media which brings the oropharyngeal pathogens down to the respiratory track. Methods. Two‐group comparison study design was adopted. Subjects were recruited from an adult general intensive care unit of a medical centre in Taipei city. Patients in the study group received suction of oral secretion before each positional care, in contrast with patients in the control group who received routine care. Results. Ventilator‐associated pneumonia was found in 24 of 159 (15·1%) patients in the control group and in five of 102 (4·9%) patients in the study group with a reduction of risk ratio of 0·32 (95% CI 0·11–0·92). Eight of the 24 ventilator‐associated pneumonia patients died in the control group; however, none of those ventilator‐associated pneumonia patients died in the study group. The increased chance of survival was 1·50 (95% CI 1·13–1·99). The length of stay in ICU and duration of mechanical ventilation were reduced in the study group. In consideration of cost, the cost of tubes used to remove oral secretion is much less than the one used to do continuous subglottal suction. Conclusion. Removal of oral secretion is effective in reducing the incidence of ventilator‐associated pneumonia with minimum cost intervention. Relevance to Clinical Practice. This study provides evidence that removal of oral secretion prior to position change is cost effective to reduce the incidence of ventilator‐associated pneumonia. As such intervention is an easy task, routine removal of oral secretion is recommended as the standard of daily nursing care of patients on ventilator.     

Temperature sensitivity of human perforin mutants unmasks subtotal loss of cytotoxicity,delayed FHL,and a predisposition to cancer

The pore-forming protein perforin is critical for defense against many human pathogens and for preventing a catastrophic collapse of immune homeostasis, manifested in infancy as Type 2 familial hemophagocytic lymphohistiocytosis (FHL). However, no evidence has yet linked defective perforin cytotoxicity with cancer susceptibility in humans. Here, we examined perforin function in every patient reported in the literature who lived to at least 10 years of age without developing FHL despite inheriting mutations in both of their perforin (PRF1) alleles. Our analysis showed that almost 50% of these patients developed at least 1 hematological malignancy in childhood or adolescence. The broad range of pathologies argued strongly against a common environmental or viral cause for the extraordinary cancer incidence. Functionally, what distinguished these patients was their inheritance of PRF1 alleles encoding temperature-sensitive missense mutations. By contrast, truly null missense mutations with no rescue at the permissive temperature were associated with the more common severe presentation with FHL in early infancy. Our study provides the first mechanistic evidence for a link between defective perforin-mediated cytotoxicity and cancer susceptibility in humans and establishes the paradigm that temperature sensitivity of perforin function is a predictor of FHL severity.     

DNA methylation regulates constitutive expression of Stat6 regulatory genes SOCS-1 and SHP-1 in colon cancer cells

Purpose  

Stat6 signaling is active in cancer cells and IL-4-induced Stat6 activities or Stat6 activational phenotypes vary among cancer cells. This study aimed at investigating possible mechanism(s) involved in the formation of varying Stat6 activities/phenotypes.     

家庭亲密度、适应性与不孕症患者就诊行为研究

本文采用家庭亲密度和适应性作为家庭环境因素对不孕症患者就诊行为影响的指标,探讨家庭对患者就诊行为产生的影响。数据表明,就诊患者的家庭亲密度较高,适应性适中,提示正常的家庭功能是推动患者就诊行为正常化的基础。