青海地区非小细胞肺癌患者PLR、NLR、SIRI、HSP90α预测EGFR基因突变的临床价值研究

摘要 目的：探讨青海地区非小细胞肺癌（NSCLC）患者血小板/淋巴细胞比值（PLR）、中性粒细胞/淋巴细胞比值（NLR）、系统性炎症反应指数（SIRI）、热休克蛋白90α（HSP90α）预测表皮生长因子受体（EGFR）基因突变的临床价值。方法：选择2020年3月至2023年3月青海大学附属医院收治的青海地区135例NSCLC且行EGFR基因检测的患者为研究对象,根据EGFR突变发生情况将患者分为EGFR突变型组（64例）与野生型组（71例）。检测PLR、NLR、SIRI、HSP90α。采用多因素Logistic回归分析EGFR基因突变的影响因素,受试者工作特征（ROC）曲线分析PLR、NLR、SIRI、HSP90α联合应用预测NSCLC患者发生EGFR基因突变的效能。结果：EGFR突变型组血浆HSP90α水平高于野生型组（P＜0.05）,PLR、NLR、SIRI低于野生型组（P＜0.05）。多因素Logistic回归分析显示,女性、腺癌、高HSP90α是NSCLC患者发生EGFR基因突变的危险因素（P＜0.05）,高PLR、NLR、SIRI是保护因素（P＜0.05）。PLR、NLR、SIRI、HSP90α预测NSCLC患者发生EGFR基因突变的曲线下面积为0.783、0.826、0.815、0.811,联合预测曲线下面积为0.932,高于单独预测。结论：青海地区EGFR基因突变的NSCLC患者PLR、NLR、SIRI降低,HSP90α增高。联合PLR、NLR、SIRI,HSP90α对EGFR基因突变的发生具有较高的预测价值。     

血清OPN、Wip1、HSP90α与晚期非小细胞肺癌患者一线化疗敏感性和预后的关系

摘要 目的：探讨血清骨桥蛋白（OPN）、野生型p53诱导的磷酸酶1（Wip1）、热休克蛋白90α（HSP90α）与晚期非小细胞肺癌（NSCLC）患者一线化疗敏感性和预后的关系。方法：选取2018年1月～2020年1月在河北医科大学附属第一医院接受一线化疗方案治疗的晚期NSCLC患者137例，根据化疗疗效分为化疗不敏感组（38例）和化疗敏感组（99例）。采用酶联免疫吸附法检测血清OPN、HSP90α水平，实时荧光定量聚合酶链式反应检测血清Wip1 mRNA水平。多因素Logistic回归分析影响晚期NSCLC患者一线化疗敏感性的因素。随访3年，Kaplan-Meier法分析高/低血清OPN、Wip1 mRNA、HSP90α水平晚期NSCLC患者一线化疗后的预后情况。结果：与化疗敏感组比较，化疗不敏感组血清OPN、Wip1 mRNA、HSP90α水平升高（P＜0.05）。多因素Logistic回归分析显示，低分化、TNM分期Ⅳ期和血清OPN、Wip1 mRNA、HSP90α水平升高为影响晚期NSCLC患者一线化疗敏感性的独立危险因素（P＜0.05）。随访3年，137例晚期NSCLC患者总生存率为15.33%（21/137）。Kaplan-Meier生存曲线显示，血清OPN、Wip1 mRNA、HSP90α高水平组3年总生存率低于血清OPN、Wip1 mRNA、HSP90α低水平组（P＜0.05）。结论：血清OPN、Wip1、HSP90α水平升高与晚期NSCLC患者一线化疗敏感性下降和预后不良有关。     

血清CEA、G-17、MK、ProGRP与胃癌根治术患者术后复发风险的关系研究

摘要 目的：探讨血清癌胚抗原（CEA）、胃泌素17（G-17）、中期因子（MK）、胃泌素释放肽前体（ProGRP）与胃癌根治术（RG）患者术后复发风险的关系。方法：选取2018年1月～2020年8月新疆医科大学第一附属医院普外科收治的156例胃癌患者为胃癌组,根据RG后是否复发分为复发组和无复发组,另选取同期我院52名健康体检志愿者为对照组。收集胃癌患者临床资料,采用酶联免疫吸附法检测血清CEA、G-17、MK、ProGRP水平。通过单因素和多因素Logistic回归分析RG患者术后复发的影响因素,受试者工作特征（ROC）曲线分析血清CEA、G-17、MK、ProGRP水平对RG患者术后复发的预测价值。结果：与对照组比较,胃癌组血清CEA、G-17、MK、ProGRP水平升高（P＜0.05）。随访2年,失访2例,154例RG患者术后复发率为28.57%（44/154）。多因素Logistic回归分析显示,CEA、G-17、MK、ProGRP升高、TNM分期Ⅲ期、分化程度为低分化、淋巴结转移为RG患者术后复发的独立危险因素（P＜0.05）。ROC曲线分析显示,血清CEA、G-17、MK、ProGRP水平联合预测RG患者术后复发的曲线下面积（AUC）大于CEA、G-17、MK、ProGRP单独预测。结论：血清CEA、G-17、MK、ProGRP水平升高与RG患者术后复发密切相关,可能成为RG患者术后复发的辅助预测指标,且血清CEA、G-17、MK、ProGRP联合预测RG患者术后复发的价值较高。     

血清TAP、PDCD-5、TNF-α与晚期非小细胞肺癌患者抗PD-1治疗疗效的关系分析

摘要 目的：探讨血清肿瘤异常蛋白（TAP）、程序化细胞死亡分子5（PDCD-5）、肿瘤坏死因子-α（TNF-α）与晚期非小细胞肺癌（NSCLC）患者抗程序性死亡受体1（PD-1）治疗疗效的关系。方法：选取2018年3月至2021年3月徐州医科大学附属沭阳医院肿瘤科收治的87例晚期NSCLC患者，均行抗PD-1治疗，根据治疗疗效分为疾病控制组（67例）和疾病进展组（20例）。检测对比两组患者治疗前后血清TAP、PDCD-5、TNF-α水平，收集临床资料，采用多因素Logistic回归分析NSCLC患者抗PD-1治疗疗效的影响因素，绘制受试者工作特征（ROC）曲线分析TAP、PDCD-5、TNF-α水平对NSCLC患者抗PD-1治疗疗效的评估价值。结果：疾病控制组患者治疗后血清TAP水平降低，PDCD-5、TNF-α水平升高（P＜0.05）；疾病进展组患者治疗前后血清TAP、PDCD-5、TNF-α水平比较无统计学差异（P＞0.05）；治疗后，疾病控制组患者血清TAP水平低于疾病进展组患者，PDCD-5、TNF-α水平高于疾病进展组患者（P＜0.05）。多因素Logistic回归分析结果显示：治疗前TAP水平以及远处转移是 NSCLC患者抗PD-1治疗疗效的危险因素（P＜0.05），治疗前PDCD-5、TNF-α水平是保护因素（P＜0.05）。ROC曲线分析结果显示：联合检测治疗前血清TAP、PDCD-5、TNF-α评估NSCLC患者抗PD-1治疗疗效的曲线下面积（AUC）为0.892，高于上述三项指标单独检测的0.649、0.647、0.787。结论：晚期NSCLC患者抗PD-1治疗前血清TAP、PDCD-5、TNF-α与治疗疗效相关，可用于辅助评估抗PD-1疗效。     

血清TAP、TFF3与晚期胃癌患者含奥沙利铂化疗方案敏感性和预后的关系

摘要 目的：探讨血清肿瘤异常蛋白（TAP）、三叶因子3（TFF3）与晚期胃癌患者应用含奥沙利铂化疗方案敏感性和预后的关系。方法：选择2017年1月至2020年1月河北大学附属医院收治的115例晚期胃癌患者,所有患者接受含奥沙利铂化疗方案治疗,根据疗效分为敏感组（47例）和耐药组（68例）。化疗前检测血清TAP、TFF3水平,受试者工作特征（ROC）曲线分析TAP、TFF3预测晚期胃癌患者接受含奥沙利铂化疗疗效的价值。治疗后随访,Wilcoxon检验不同血清TAP、TFF3表达下晚期胃癌患者中位OS时间差异。结果：耐药组血清TAP、TFF3水平高于敏感组（P＜0.05）。TAP、TFF3预测晚期胃癌患者含奥沙利铂化疗耐药的曲线下面积分别为0.717、0.690,联合TAP和TFF3预测晚期胃癌患者含奥沙利铂化疗耐药的曲线下面积为0.801,高于单独TAP、TFF3单独检测。随访期间失访2例,死亡54例,高水平TAP、高水平TFF3晚期胃癌患者中位OS时间短于低水平TAP、低水平TFF3晚期胃癌患者（P＜0.05）。结论：对含奥沙利铂化疗耐药的晚期胃癌患者血清TAP、TFF3水平显著增高,高水平TAP、TFF3晚期胃癌患者中位OS时间较短,联合检测血清TAP和TFF3可预测晚期胃癌患者化疗反应性和预后。     

参附注射液联合奥西替尼治疗晚期EGFR阳性非小细胞肺癌患者疗效及对患者免疫功能的影响

摘要 目的：探讨分析参附注射液联合奥西替尼治疗晚期EGFR阳性非小细胞肺癌（Non-small cell lung cancer,NSCLC）患者疗效及对患者免疫功能的影响。方法：选择2018年6月~2020年12月我院收治的EGFR突变阳性晚期NSCLC患者96例,随机分为观察组50例、对照组46例,对照组给予奥西替尼口服治疗,观察组在对照组基础上给予参附注射液,两组均治疗16周。比较两组治疗临床疗效、免疫功能指标及患者生活质量评分结果。结果：治疗前,两组T淋巴细胞亚群水平和EORCT-QLQ-C30评分差异均无统计学意义（P>0.05）;治疗后,与对照组相比,观察组患者治疗有效率、CD4⁺/CD8⁺比值、功能领域及总体健康状况评分均显著增加,而外周血CD8⁺水平、症状领域评分均显著降低（P<0.05）。结论：参附注射液联合奥西替尼治疗晚期EGFR阳性NSCLC患者可有效提高临床治疗效果,改善患者机体免疫功能并提高患者生活质量,值得临床推广。     

妊娠合并乙肝病毒感染患者血清DNMT1、TIM-3与HBV-DNA病毒载量和妊娠结局的关系分析

摘要 目的：探讨妊娠合并乙肝病毒（HBV）感染患者血清脱氧核糖核酸甲基转移酶1（DNMT1）、T细胞免疫球蛋白粘蛋白-3（TIM-3）与乙型肝炎病毒-脱氧核糖核酸（HBV-DNA）病毒载量和妊娠结局的关系。方法：选取2021年1月～2022年1月南京医科大学第一附属医院收治的186例妊娠合并HBV感染患者为HBV感染组,根据HBV-DNA病毒载量分为阳性组56例和阴性组130例,根据妊娠结局分为结局不良组和结局良好组,另选取同期于南京医科大学第一附属医院进行孕检的150名健康孕妇为对照组。采用酶联免疫吸附法检测血清DNMT1、TIM-3水平。比较HBV感染组与对照组、阳性组与阴性组血清DNMT1、TIM-3水平。采用单因素及多因素Logistic回归分析妊娠合并HBV感染患者妊娠结局不良的影响因素,受试者工作特征（ROC）曲线分析血清DNMT1、TIM-3水平对妊娠合并HBV感染患者妊娠结局不良的预测价值。结果：与对照组比较,HBV感染组血清DNMT1、TIM-3水平升高（P＜0.05）。与阴性组比较,阳性组血清DNMT1、TIM-3水平升高（P＜0.05）。186例妊娠合并HBV感染患者妊娠结局不良发生率为55.38%（103/186）。单因素分析显示,妊娠结局不良与HBV感染孕周、HBV-DNA病毒载量、谷草转氨酶（AST）、谷丙转氨酶（ALT）、DNMT1、TIM-3有关（P＜0.05）。多因素Logistic回归分析显示,HBV-DNA病毒载量阳性和DNMT1＞34.94 ng/mL、TIM-3＞18.96 pg/mL为妊娠合并HBV感染患者妊娠结局不良的独立危险因素（P＜0.05）。ROC曲线分析显示,血清DNMT1、TIM-3水平单独和联合检测预测妊娠合并HBV感染患者妊娠结局不良的曲线下面积分别为0.798、0.791、0.870。结论：妊娠合并HBV感染患者血清DNMT1、TIM-3水平升高与HBV-DNA病毒载量阳性和妊娠结局不良密切相关,血清DNMT1、TIM-3水平联合对妊娠合并HBV感染患者妊娠结局预测价值良好。     

HPV-DNA、p16和EGFR在口咽癌诊断中的临床价值分析

摘要 目的：探讨人乳头状瘤病毒感染状态（HPV-DNA）、p16基因和表皮生长因子受体（EGFR）在口咽癌诊断中的临床价值。方法：选取我院2015年5月到2021年10月共收治的口咽癌60患者作为研究对象,进行回顾性分析,分析HPV-DNA、p16和EGFR在口咽癌患者的表达情况,分析HPV-DNA、p16和EGFR与肿瘤病理的关系,之后对所有患者进行随访,应用Cox比例风险回归模型分析患者的生存情况与HPV-DNA、p16和EGFR的关系。结果：HPV-DNA、p16和EGFR在口咽癌患者中的阳性表达对比无明显差异（P＜0.05）;HPV-DNA阳性患者与阴性患者性别、年龄对比无明显差异（P＞0.05）,肿瘤分期与淋巴结受累情况对比差异显著（P＜0.05）;p16阳性患者与阴性患者性别、年龄、肿瘤分期对比无差异（P＞0.05）,淋巴结受累情况对比差异显著（P＜0.05）;EGFR阳性患者与阴性患者性别、年龄对比无明显差异（P＞0.05）,肿瘤分期与淋巴结受累情况对比差异显著（P＜0.05）;在患者生存分析之中,有20例患者因为随访数据不全被剔除,其中无病生存率之中,P16/EGFR、p16对比差异显著（P＜0.05）,总生存率中淋巴结转移、P16/EGFR对比差异显著（P＜0.05）;口咽癌中HPV-DNA水平与p16水平呈现负相关关系,与EGFR呈现正相关关系,p16与EGFR呈现负相关关系（P＜0.05）。结论：p16的表达是口咽癌最可靠的预后标志物,而且可能是HPV阳性口咽癌的替代标记物。HPV1/p161肿瘤倾向于减少EGFR的表达,但使用两种免疫组织学标记物对预后有显著影响。     

血浆循环游离DNA(cf DNA)联合癌胚抗原(CEA)在评估晚期非小细胞肺癌治疗疗效的临床价值

摘要 目的：研究血浆循环游离DNA（cf DNA）联合癌胚抗原（CEA）在评估晚期非小细胞肺癌（NSCLC）治疗疗效中的临床价值。方法：选取我院2019年1月~2022年1月收治的96例晚期NSCLC患者作为研究对象,所有患者均接受含铂双药化疗方案或放疗,评估治疗6个月后的临床疗效,根据疗效分为有效组与无效组,检测所有患者cf DNA及CEA水平并进行比较,单因素、多因素分析患者疗效的影响因素,并通过受试者工作特征曲线图（ROC）分析cf DNA及CEA对晚期NSCLC患者治疗疗效的评估价值。结果：本研究中96例患者均顺利完成化疗治疗,疗程结束后,有54例（56.25%）治疗有效,42例（43.75%）治疗无效;无效组肿瘤TNM分期Ⅳ期、体力状况（PS）评分2~4分占比大于有效组（P＜0.05）;无效组患者cf DNA及CEA水平明显高于有效组（P＜0.05）;多因素Logistic回归分析显示,肿瘤分期Ⅳ期、PS评分2~4分、cf DNA及CEA高水平均为影响晚期NSCLC患者疗效的相关因素（P＜0.05）;ROC曲线分析显示,cf DNA、CEA对晚期NSCLC患者治疗后无效均有预测效能（P＜0.05）,其中两指标联合预测的曲线下面积（AUC）最大,为0.794,特异度、敏感度分别为85.19%、78.57%。结论：治疗无效晚期非小细胞肺癌患者cf DNA及CEA水平更高,肿瘤分期Ⅳ期、PS评分2~4分、cf DNA及CEA高水平均为晚期NSCLC患者疗效的影响因素,联合cf DNA及CEA检测有利于对晚期NSCLC患者治疗疗效进行评估。     

不同病情急性呼吸窘迫综合征患者血清铁蛋白、血管生成素样蛋白4、降钙素原与白蛋白比值的变化及对预后的评估价值

摘要 目的：探讨不同病情急性呼吸窘迫综合征（ARDS）患者血清铁蛋白、血管生成素样蛋白4（ANGPTL4）、降钙素原与白蛋白比值（PAR）的变化及对预后的评估价值。方法：选取2019年3月至2022年6月四川大学华西第四医院重症医学科收治的109例ARDS患者,根据氧合指数（PaO₂/FiO₂）将患者分为轻度组（200 mmHg＜PaO₂/FiO₂≤300 mmHg,38例）、中度组（100 mmHg＜PaO₂/FiO₂≤200 mmHg,42例）、重度组（≤100 mmHg,29例）。检测所有ARDS患者血清铁蛋白、ANGPTL4水平及PAR,根据患者入院后28 d内生存状况将其分为存活组（69例）、死亡组（40例）。多因素Logistic回归分析ARDS患者入院后28 d内死亡的危险因素。受试者工作特征（ROC）曲线分析血清铁蛋白、ANGPTL4、PAR评估ARDS患者预后的预测价值。结果：重度组血清铁蛋白、ANGPTL4、降钙素原及PAR高于中度组和轻度组（P＜0.05）,血清白蛋白水平低于中度组和轻度组（P＜0.05）。死亡组血清铁蛋白、ANGPTL4、降钙素原及PAR高于存活组（P＜0.05）,血清白蛋白水平低于存活组（P＜0.05）。高SOFA评分、高PAR及血清铁蛋白、ANGPTL4水平升高是 ARDS患者入院28 d内死亡的危险因素（P＜0.05）。联合血清铁蛋白、ANGPTL4、PAR三项指标预测ARDS患者预后的曲线下面积为0.867,高于单独指标预测的0.775、0.727、0.776。结论：ARDS患者血清铁蛋白、ANGPTL4水平及PAR增高与病情加重以及预后不良有关,联合检测三项指标在ARDS患者预后评估中具有较高价值。     

白蚁与动物及微生物的共生类型及其机制

综述了白蚁螱客的主要种类、共生关系及相关机制的研究进展。白蚁螱客中,已报道的动物种类达170种。在与动物的共生关系中存在偏利共生（宾主共栖和异种共栖）、互利共生和无关共生三种;在与微生物的共生关系中,存在与内生菌（原生动物、细菌、真菌和放线菌）和外生菌（蚁巢伞菌等）间的互利关系。指出了白蚁与螱客研究中存在的问题,给出了解决方案,并提出了今后可能的研究热点或方向,为白蚁的综合利用（如纤维素酶）及今后研究物种间的协同进化提供了基础资料。     

New amino-dithiaphospholanes and phosphoramidodithioites and their rhodium and iridium complexes

New sulfur derivatives of phosphoramidite ligands were synthesized and the impact of the sulfur unit on the spectroscopic properties of their rhodium and iridium complexes was investigated. The new ligands Bn₂NPSCH₂CH₂S^a(P-S^a) (Bn = benzyl, 4), Bn₂NPSCHCHS^a(CH₂)₃C^aH₂(P-S^a)(C^a-S^a) (6) and Bn₂NP(4-XC₆H₄OMe)₂ (X = S, 7a; X = O, 7b) were converted to the rhodium and iridium complexes trans-[Rh(CO)Cl(L)₂] (L = 4, 6, 7), [RhCl(COD)(L)] (L = 4, 6, 7), [IrCl(COD)(7a)] and [IrCl₂Cp∗(6)]. For comparison, some phosphoramidite complexes of these formulations also were synthesized. The new metal complexes were spectroscopically analyzed. For the carbonyl complexes, the ν_CO IR stretching frequencies were lower than for the corresponding phosphite and phosphoramidite ligands. The ¹J_PRh coupling constants for the rhodium complexes with the new ligands were also smaller than for the respective phosphoramidite and phosphite complexes. Finally, the ¹J_PSe coupling constants of the selenides of the new ligands were lower than those of the phosphoramidite ligands but higher than for PPh₃. The spectroscopic data reveal that the new thio ligands 4, 6 and 7a are more electron donating than phosphites and phosphoramidites but less electron donating than PPh₃.     

Astrocytes and Synaptosomes Transport and Metabolize Lactate and Acetate Differently

Astrocytes transport the monocarboxylate acetate, but synaptosomes do not. The reason for this is unknown, because both preparations express monocarboxylate transporters (MCT). The transport and metabolism of lactate, another monocarboxylate, was examined in these two preparations, and the results were compared to those for acetate. Lactate transport is more rapid in astrocytes than in synaptosomes, but of lower affinity (Kms of 17 and 4 mM, respectively). Lactate (0.2 mM) is metabolized to CO2 more rapidly in synaptosomes than in astrocytes (rates of 0.37 and 0.07 nmol x mg protein(-1) x min(-1), respectively). The reason for this is unclear, but cellular differences in lactate dehydrogenase isotype expression may be involved. Acetate is metabolized to CO2 more rapidly in astrocytes than in synaptosomes (rates of 0.43 and 0.02 nmol x mg protein(-1) x min(-1), respectively). This is likely due to cellular differences in the expression of monocarboxylate transporter subtypes.     

Rapporteur report: Basics and technology and metrology and standards

The first and second sessions of the Workshop focussed on the basics of ultrasound and infrasound, their applications in both industry and medicine, and metrology and protection standards for ultrasound applications.     

Relative and combined effects of ethanol and protein deficiency on strontium and barium bone content and fecal and urinary excretion

To elucidate accumulation of minerals in human iliac arteries with aging, the content of minerals was analyzed by inductively coupled plasma atomic emission spectrometry. Bilateral common, internal, and external iliac arteries of 16 men and 8 women, ranging ages from 65 to 93 yr, were examined. It was found that an extremely high accumulation of calcium and phosphorus occurred in the common iliac artery at old age, being higher than that of the internal and external iliac arteries. It should be noted that the accumulation of calcium and phosphorus is the highest in the common iliac artery among the human arteries examined to date. Regarding sexual differences, the content of calcium and phosphorus in the common and internal iliac arteries was higher in women than in men, whereas their content in the external iliac artery was lower in women than in men.     

Prostaglandin and thromboxane production by human and guinea-pig macrophages and leucocytes

The ability of partially purified human and guinea-pig haematogenous cell populations, when cultured in vitro, to metabolise arachidonic acid (AA) has been studied. Supernatants from 24 hour cell culture have been subjected to analysis for products of AA metabolism by gas chromatography with electron-capture detection.The cell types studied were human peripheral blood monocytes (both glass adherent and non-adherent), neutrophils, eosinophils and leukemic leucocytes; thoracic duct lymphocytes and lung alveolar macrophages. From the guinea-pig, induced and non-induced macrophage or neutrophil enriched peritoneal exudate populations, lymph node cells, peritoneal eosinophils and peripheral blood platelets were examined. Supernatants were assayed for the presence of PGE₂, PGD₂, PGF_2α, TXB₂ and 6-keto-PGF_1α. In all types studied PGE₂ and TXB₂ were the major products formed. The identification of PGE₂ and TXB₂ was confirmed by GC/MS with multiple ion monitoring.The results have been compared with other reports and their possible significance discussed in relation to the proposed role of prostaglandins as mediators and modulators in immunopathology.     

Chemokines and cytokines: axis and allies in asthma and allergy

Allergic asthma can be precipitated by many factors. For the atopic person, fungus, pollen, dust mites, cockroach antigens, and diesel exhaust are all agents that may trigger an allergic attack. Cytokines and chemokines are integral mediators of fungal asthma. From the earliest time points, they recruit and activate the cells required for the clearance of fungus as well as being critical factors involved in the immunopathology of this disease. In the final analysis, it is clear that these mediators can act to the benefit or the detriment of the host.     

Oxidation and nitration of ribonuclease and lysozyme by peroxynitrite and myeloperoxidase

In spite of the many studies on protein modifications by reactive species, knowledge about the products resulting from the oxidation of protein-aromatic residues, including protein-derived radicals and their stable products, remains limited. Here, we compared the oxidative modifications promoted by peroxynitrite and myeloperoxidase/hydrogen peroxide/nitrite in two model proteins, ribonuclease (6Tyr) and lysozyme (3Tyr/6Trp). The formation of protein-derived radicals and products was higher at pH 5.4 and 7.4 for myeloperoxidase and peroxynitrite, respectively. The main product was 3-nitro-Tyr for both proteins and oxidants. Lysozyme rendered similar yields of nitro-Trp, particularly when oxidized by peroxynitrite. Hydroxylated and dimerized products of Trp and Tyr were also produced, but in lower yields. Localization of the main modified residues indicates that peroxynitrite decomposes to radicals within the proteins behaving less specifically than myeloperoxidase. Nitrogen dioxide is emphasized as an important protein modifier.