中老年健康体检人群多项肿瘤标志物筛查结果及与年龄和性别的关系分析

摘要 目的：研究中老年健康体检人群多项肿瘤标志物（TM）筛查结果,分析其与年龄和性别的关系。方法：将自2017年6月至2019年12月于我院接受健康体检的600例中老年体检者纳入研究,分别以流式荧光发光法检测甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原-153（CA-153）、糖类抗原-125（CA-125）水平,并分析不同性别、年龄的体检者上述TM阳性率情况,分析各项TM阳性率检出疾病情况。结果：600例体检者AFP、CEA、CA-153、CA-125水平分别为（17.48±3.84）ng/mL、（4.54±1.19）ng/mL、（29.23±7.10）U/mL、（30.65±6.39）U/mL,阳性率分别为1.67%、4.00%、3.33%、3.83%。男性体检者CEA及CA-153阳性率均高于女性,而CA-125阳性率低于女性（P＜0.05）;男性与女性AFP阳性率对比不明显（P＞0.05）。81～89岁体检者的AFP、CEA、CA-153、CA-125阳性率均高于其他年龄段体检者（P＜0.05）。AFP、CEA、CA-153、CA-125阳性体检者恶性肿瘤检出率较低。结论：AFP、CEA、CA-153、CA-125表达升高,可能是中老年人群肿瘤发生、发展的早期预警,应予以高度重视,且和年龄、性别关系密切。中老年人群定期体检能够早期发现疾病并治疗,防止疾病继续恶化,保证身心健康。     

Intersession reliability of a posturo-stabilometric test,using a force platform

Aim of the studyTo evaluate the intersession reliability of a posturo-stabilometric examination.MethodsSingle blind clinical trial conducted in two sessions over two weeks.44 healthy volunteers free from postural and temporomandibular disorders. All the subjects complied with the criteria for completing the study.All the subjects underwent two sessions of posturo-stabilometric examinations in different visual and mandibular conditions.Sway area, sway length and the coordinates of the center of pressure were evaluated and statistically analyzed using the Intraclass correlation coefficient (ICC).ResultsAll the posturo-stabilometric parameters seemed to have an excellent reproducibility with overall ICCs higher than 70% and good confidence intervals except for the sway area (ICC 0.422 with CI 0.283–0.560 with open eyes and ICC 0.554 with CI 0.424–0.683 with closed eyes).ConclusionsThe posturo-stabilometric examination carried out using a force platform has a good intrasession and intersession reliability, especially considering sway velocity, COP X and COP Y parameters. The force platform usefulness in analyzing static posture is confirmed in any medical field.     

Familial Creutzfeldt-Jakob Disease: Case report and role of genetic counseling in post mortem testing

Here we present a case of an asymptomatic 53-year-old woman who sought genetic testing for Familial Creutzfeldt-Jakob Disease (fCJD) after learning that her mother had fCJD. The patient's mother had a sudden onset of memory problems and rapidly deteriorating mental faculties in her late 70s, which led to difficulties ambulating, progressive non-fluent aphasia, dysphagia and death within ～1 y of symptom onset. The cause of death was reported as “rapid onset dementia.” The patient's family, unhappy with the vague diagnosis, researched prion disorders online and aggressively pursued causation and submitted frozen brain tissue from the mother to the National Prion Disease Surveillance Center, where testing revealed a previously described 5-octapeptide repeat insertion (5-OPRI) in the prion protein gene (PRNP) that is known to cause fCJD. The family had additional questions about the implications of this result and thus independently sought out genetic counseling.

?While rare, fCJD is likely underdiagnosed due to clinical heterogeneity, rapid onset, early non-specific symptomatology, and overlap in the differential diagnosis of Alzheimer disease and Lewy body dementias. When fCJD is identified, a multidisciplinary approach to return of results that includes the affected patient's provider, genetics professionals, and mental health professionals is key to the care of the family. We present an example case which discusses the psychosocial issues encountered and the role of genetic counseling in presymptomatic testing for incurable neurodegenerative conditions. Ordering physicians should be aware of the basic issues surrounding presymptomatic genetic testing and identify local genetic counseling resources for their patients.     

Monitoring population‐level responses of marine mammals to human activities

We provide guidance for monitoring whether human activities affect the physiology or behavior of marine mammals and, if so, whether those effects may lead to changes in survival and reproduction at the population level. We suggest that four elements be included in designing and implementing such a monitoring program. The first is development of a theory of change: a set of mechanistic hypotheses that outline why a given activity might be expected to have one or more measurable effects on individuals and populations, and ideally the magnitude, timing, and duration of the effects. The second element, definition of biologically meaningful effect sizes, ultimately facilitates the development of a monitoring program that can detect those magnitudes of effect with the desired levels of precision. The third element, selection of response variables for monitoring, allows inference to whether observed changes in the status of individuals or populations are attributable to a given activity. Visual observations, passive acoustic and tagging instruments, and direct physical measurements all can provide data that facilitate quantitative hypothesis testing. The fourth element is specification of the temporal sequence of monitoring. These elements also can be used to inform monitoring of the responses of other taxonomic groups to human activities.     

尿激酶原的性质、结构、功能及其药代动力学和临床应用效果

溶栓疗法不仅已被常规地用于急性心肌梗死的治疗,而且也已用于其它血栓病的治疗中,如急性缺血性脑血栓、肺栓塞、急性周围动脉血栓等。尿激酶原是双链尿激酶的单链前体,它主要激活纤维蛋白表面的纤溶蛋白原,所以具有选择性溶栓作用。临床结果表明它是一种安全有效的溶栓药物,与t-PA、链激酶或尿激酶伍用均有协同作用。本文综述它了的特性、结构与功能,以及它的药代动力学和临床的治疗效果。     

Evaluation of three indices for biofilm accumulation on complete dentures

doi:10.1111/j.1741‐2358.2009.00285.x
Evaluation of three indices for biofilm accumulation on complete dentures Objectives: The objective of this study was to evaluate the accuracy and reproducibility of three complete denture biofilm indices (Prosthesis Hygiene Index; Jeganathan et al. Index; Budtz‐Jørgensen Index) by means of a computerised comparison method. Background: Clinical studies into denture hygiene have employed a large number of biofilm indices among their outcome variables. However, the knowledge about the validity of these indices is still scarce. Materials and methods: Sixty‐two complete denture wearers were selected. The internal surfaces of the upper complete dentures were stained (5% erythrosine) and photographed. The slides were projected on paper, and the biofilm indices were applied over the photos by means of a scoring method. For the computerised method, the areas (total and biofilm‐covered) were measured by dedicated software (Image Tool). In addition, to compare the results of the computerised method and Prosthetic Hygiene Index, a new scoring scale (including four and five graded) was introduced. For the Jeganathan et al. and Budtz‐Jørgensen indices, the original scales were used. Values for each index were compared with the computerised method by the Friedman test. Their reproducibility was measured by means of weighed κ. Significance for both tests was set at 0.05. Results: The indices tested provided similar mean measures but they tended to overestimate biofilm coverage when compared with the computerised method (p < 0.001). Agreement between the Prosthesis Hygiene Index and the computerised method was not significant, regardless of the scale used. Jeghanathan et al. Index showed weak agreement, and consistent results were found for Budtz‐Jorgensen Index (κ = 0.19 and 0.39 respectively). Conclusion: Assessment of accuracy for the biofilm indices showed instrument bias that was similar among the tested methods. Weak inter‐instrument reproducibility was found for the indices, except for the Budtz‐Jørgensen Index. This should be the method of choice for clinical studies when more sophisticated approaches are not possible.     

Using provenance to manage knowledge of in silico experiments

This article offers a briefing in one of the knowledge management issues of in silico experimentation in bioinformatics. Recording of the provenance of an experiment-what was done; where, how and why, etc. is an important aspect of scientific best practice that should be extended to in silico experimentation. We will do this in the context of eScience which has been part of the move of bioinformatics towards an industrial setting. Despite the computational nature of bioinformatics, these analyses are scientific and thus necessitate their own versions of typical scientific rigour. Just as recording who, what, why, when, where and how of an experiment is central to the scientific process in laboratory science, so it should be in silico science. The generation and recording of these aspects, or provenance, of an experiment are necessary knowledge management goals if we are to introduce scientific rigour into routine bioinformatics. In Silico experimental protocols should themselves be a form of managing the knowledge of how to perform bioinformatics analyses. Several systems now exist that offer support for the generation and collection of provenance information about how a particular in silico experiment was run, what results were generated, how they were generated, etc. In reviewing provenance support, we will review one of the important knowledge management issues in bioinformatics.     

The value of juvenile animal studies “What have we learned from preclinical juvenile toxicity studies? II”

Recent changes in the regulations from the FDA and EMA have shifted the focus of juvenile toxicity studies more to the safe use of all pharmaceuticals and the absence of label or safety information for the pediatric population. Unlike other regulatory guidance, the need or design of these animal studies is not specified. Ideally these should be decided “case‐by‐case” based on the patient population, pharmacology, existing toxicological and clinical data, dosing regimen, and developing system impact. Following the publishing of a small intercompany survey (Bailey and Mariën, 2009), a more extensive survey was commissioned by the ILSI/HESI DART Technical Committee to clarify what has been learned for the safety assessment for pediatrics. Contributions from 24 companies totaling 241 studies (84% rat and 14% dog) were received. In 12 of 82 programs (15%) were the existing adult preclinical or clinical data considered a sufficient safety prediction for pediatric trials. Clinical/preclinical correlates were observed in 17.2% (rat) and 42.9% (dog) of the studies and a lack of predictability from the pharmacology or the adult toxicity data was seen in 25% of rat and 14.3% of dog studies. Many of the studies were large, lengthy, complex, included parameters that mirrored the adult studies and yielded no new or useful information. We should avoid conducting complex or inappropriate studies and Contract Research Organisations and regulatory agencies have a role in encouraging more targeted designs. Only with appropriate designs can we adequately identify safety or pharmacokinetic issues, suggest clinical endpoints, and contribute to the product label. Birth Defects Res (Part B) 92:273–291, 2011. © 2011 Wiley‐Liss, Inc.     

血清与血浆中HBsAg在全自动酶免分析检测结果比较

目的：探讨血浆取代血清检测乙肝标志物的检测结果以及临床意义。方法：选取我科检测乙肝标志物的血样30份,分别放在抗凝剂管和普通干燥试管,采用全自动酶免疫分析仪检测HBsAg,将检测结果进行OD及S/CO值统计处理,并进行比较分析。结果：血清与二种血浆检测结果相关系数均0.99,二种血浆与血清结果相关关系良好（P〉0.0 5）,无显著性差异。结论：血浆代替血清完全可以用于全自动酶标分析仪进行检测,既可以节省预处理时间,又可以减少标本在分离吸移血清过程中出现差错,值得临床推广和应用。     

Development of a multiple internal control for clinical diagnostic real-time amplification assays

A major pitfall in most published genomic amplification methods for the detection and identification of human pathogens is that they do not include an internal amplification control in order to achieve an acceptable level of confidence for the absence of false-negative results. By applying composite primer technology, a single multiple internal amplification control DNA molecule was constructed to detect and quantify the hepatitis B virus, human polyomavirus, Epstein-Barr virus, Toxoplasma gondii and cytomegalovirus using real-time PCR. The multiple internal amplification control contains all forward and reverse primer binding regions targeted in the five distinct duplex PCRs, but with a unique probe hybridization site. Multiple internal amplification control detection sensitivity, assessed by Probit analysis, was 58 copies per PCR, associated with an extremely wide dynamic range (8 log(10) units). Moreover, in testing 614 patient samples, PCR inhibition occurred at a frequency of 0-8.8%. Similar multiple internal amplification controls for quantitative PCR-based assays could be designed to accommodate any infectious profiles in a particular institution as they are easy to make and inexpensive.