[Clinical application of adult comorbidity evaluation-27 in endometrial cancer]

Objective: To investigate the significant role of the clinical application of adult comorbidity evaluation-27 (ACE-27) in endometrial cancer (EC). Methods: A total of 847 EC patients were included during Jan. 1985 to Dec. 2015 from Tianjin Medical University General Hospital. The clinical data of the patients were collected and analyzed retrospectively. All of the patients were received operation with no chemotherapy and radiotherapy before operation. The average age was 57.6 years old (range from 25 to 85 years old). The average follow-up period was 59.0 months (range from 2 to 312 months). The comorbidity of the patients was evaluated by ACE-27. EC patients survival was analyzed by Kaplan-Meier survival curve. The relationship between the prognosis of EC and ACE-27, age, body mass index (BMI) , pathological characteristic were showed by Cox modeling. Results: (1) The patient number of score 0, 1, 2 and 3 of ACE-27 in EC patients were respectively 311 (36.7%), 263 (31.1%), 132 (15.6%) and 141 (16.6%) cases. (2) Kaplan-Meier survival curve analysis showed that overall survival time of EC patients was gradually decreased as increased score of ACE-27 (χ²=19.003, P=0.000) . In the patients of BMI<25 kg/m² and BMI 25-<30 kg/m², International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ, endometrial adenocarcinoma type and the overall survival time of those EC patients were gradually decreased as increased score of ACE-27 (P<0.05) . However, there was no statistically significant difference in overall survival time for patients with BMI ≥30 kg/m², FIGO stage with Ⅱ-Ⅳand non-endometrial adenocarcinoma type (P>0.05). Per unvariate logistic modeling showed that the risk of death in score 3 of ACE-27 was increased compared with score 0 of ACE-27 (OR=2.53, P=0.000) . The overall survival time in EC patients with aged 50-59, 60-69 and ≥70 years old, BMI 25-<30 kg/m² and ≥ 30 kg/m², G₃, FIGO stage Ⅱ-Ⅳ and non-endometrial adenocarcinoma type were significantly decreased compared with those aged <50 years old, BMI < 25 kg/m², G₁, FIGO stage Ⅰ and endometrial adenocarcinoma type (all P<0.05) . Further we found that postoperative chemotherapy or radiotherapy rate were decreased for EC patients with FIGO staging Ⅲ or Ⅳ as the increase of ACE-27 score, but there was no statistically significant difference (P>0.05). (3) Per multivariate logistic modeling showed that the risks of death in score 3 of ACE-27 was increased compared with score 0 of ACE-27 among age-adjusted, BMI, histological grade, FIGO stage and pathologic type (OR=2.40, P=0.000) . Per multivariate logistic modeling showed that, the overall survival time in EC patients with aged 60-69 and ≥70 years old, BMI 25-<30 kg/m² and ≥30 kg/m², FIGO stage Ⅲ-Ⅳ and non- endometrial adenocarcinoma type remain significantly decreased compared with those aged <50 years old, BMI<25 kg/m², FIGO stage Ⅰ and endometrial adenocarcinoma type (P<0.05) , but there was no statistically significant difference in histological grade (P>0.05). Conclusions: ACE-27 may become one of the factors of predictive therapy and the prognosis for EC patients. The detailed clinical data of comorbidity should be collected to evaluate prognosis and therapy plan.

Transverse single-shot cross-correlation scheme for laser pulse temporal measurement via planar second harmonic generation

We present a novel single-shot cross-correlation technique based on the analysis of the transversally emitted second harmonic generation in crystals with random distribution and size of anti-parallel nonlinear domains. We implement it to the measurement of ultrashort laser pulses with unknown temporal duration and shape. We optimize the error of the pulse measurement by controlling the incident angle and beam width. As novelty and unlike the other well-known cross correlation schemes, this technique can be implemented for the temporal characterization of pulses over a very wide dynamic range (30 fs-1ps) and wavelengths (800-2200 nm), using the same crystal and without critical angular or temperature alignment.

New generalized poisson mixture model for bimodal count data with drug effect: An application to rodent brief-access taste aversion experiments

Pharmacodynamic (PD) count data can exhibit bimodality and nonequidispersion complicating the inclusion of drug effect. The purpose of this study was to explore four different mixture distribution models for bimodal count data by including both drug effect and distribution truncation. An example dataset, which exhibited bimodal pattern, was from rodent brief-access taste aversion (BATA) experiments to assess the bitterness of ascending concentrations of an aversive tasting drug. The two generalized Poisson mixture models performed the best and was flexible to explain both under and overdispersion. A sigmoid maximum effect (Emax ) model with logistic transformation was introduced to link the drug effect to the data partition within each distribution. Predicted density-histogram plot is suggested as a model evaluation tool due to its capability to directly compare the model predicted density with the histogram from raw data. The modeling approach presented here could form a useful strategy for modeling similar count data types.

[Effects of cystectomy for ovary benign cyst on ovarian reserve and pregnancy outcome of in vitro fertilization-embryo transfer cycle]

OBJECTIVE

To investigate the impact of previous cystectomy for ovary benign cyst on ovarian reserve and pregnancy outcome in in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles.

METHODS

Totally 622 infertility patients were retrospectively investigated who underwent first IVF/ICSI-ET cycle in Reproductive Hospital Affiliated to Shandong University from January 2013 to June 2014. There were 153 cases who had been removed ovarian cyst by cystectomy surgeries recruited as study group, in which 44 cases of ovarian endometriosis cyst, 35 cases of benign ovarian teratomas, 67 cases of simple ovarian cyst and 7 cases of ovarian mucinous cystadenoma. In contrast, 469 infertility patients with tubal-factor infertility or male factor were included as control group. The age-matched women in the control group had no ovarian surgery previously. The indicators of ovarian reserve and pregnancy outcome were analyzed between two groups. The influence of different types of ovarian cysts on ovarian reserve and pregnancy outcome in IVF/ICSI-ET cycles were also studied, ovarian endometriosis cyst was studied as Group A, and Group B consisted of benign ovarian teratomas, simple ovarian cyst and mucinous cystadenoma.

RESULTS

(1) The significantly lower serum antimullerian hormone (AMH) level (median: 1.92 versus 2.90 mg/L), antral follicle count (AFC; median: 12.0 versus 13.0), retrieved oocytes (12±5 versus 13±6) and the number of embryo cryopreserved (median: 1.0 versus 3.0) were found in study group compared with control group (all P<0.05). There was no statistical difference between two group for the following parameters, such as basal FSH level, the total dosage of gonadotropin duration and the total dosage of gonadotropin (all P>0.05). A better clinical pregnancy rate was achieved in control group (61.6%, 241/391) than that in study group (61.4%, 81/132), but no significant difference was existed (P=0.96). (2) Compared to Group B, Group A had fewer AFC, lower serum AMH level, retrieved oocytes and the number of embryo cryopreserved (11±4 versus 13±5; 1.65 versus 2.15 mg/L; 9±4 versus 13±5; 0 versus 2.0; all P< 0.01). There was a lower clinical pregnancy rate in Group A than that in Group B [50.0% (19/38) versus 66.0% (62/94)], accompanying with higher abortion rate [3/19 versus 9.7% (6/62)], but no differences were observed (all P>0.05).

CONCLUSIONS

Ovarian reserve declines after the cystectomy for ovarian benign cysts and the cystectomy has a negative impact on IVF/ICSI-ET cycle, resulting in a decrease of the number of retrieved oocytes and the number of embryo cryopreserved, but do not influence clinical pregnancy outcome. Ovarian reserve is impaired more seriously by cystectomy for ovarian endometriosis cyst than other ovarian benign cyst.

Immunosuppressive human anti-CD83 monoclonal antibody depletion of activated dendritic cells in transplantation

Current immunosuppressive/anti-inflammatory agents target the responding effector arm of the immune response and their nonspecific action increases the risk of infection and malignancy. These effects impact on their use in allogeneic haematopoietic cell transplantation and other forms of transplantation. Interventions that target activated dendritic cells (DCs) have the potential to suppress the induction of undesired immune responses (for example, graft versus host disease (GVHD) or transplant rejection) and to leave protective T-cell immune responses intact (for example, cytomegalovirus (CMV) immunity). We developed a human IgG1 monoclonal antibody (mAb), 3C12, specific for CD83, which is expressed on activated but not resting DC. The 3C12 mAb and an affinity improved version, 3C12C, depleted CD83(+) cells by CD16(+) NK cell-mediated antibody-dependent cellular cytotoxicity, and inhibited allogeneic T-cell proliferation in vitro. A single dose of 3C12C prevented human peripheral blood mononuclear cell-induced acute GVHD in SCID mouse recipients. The mAb 3C12C depleted CMRF-44(+)CD83(bright) activated DC but spared CD83(dim/-) DC in vivo. It reduced human T-cell activation in vivo and maintained the proportion of CD4(+) FoxP3(+) CD25(+) Treg cells and also viral-specific CD8(+) T cells. The anti-CD83 mAb, 3C12C, merits further evaluation as a new immunosuppressive agent in transplantation.

Neuropsychological characteristics of individuals with mild cognitive impairment

Introduction

As the population ages, cognitive impairment is prevalent among older adults and this may cause a huge burden to society. In order to take precautions effectively, we need to understand the characteristics of cognitive function of older adults, especially the individuals with mild cognitive impairment (MCI).

Objectives

To explore the characteristics of cognitive function changes in individuals with mild cognitive impairment.

Methods

A total of 108 individuals with MCI as MCI group and 108 volunteers as control group were recruited in the study. The age, gender and years of schooling were matched between the two groups. The cognitive function was evaluated with the Montreal Cognitive Assessment (MoCA).

Results

Individuals of MCI group performed poorer than those of control group on executive function, attention, calculation, language and delayed memory. The difference between the two groups was statistically significant (P < 0.05). The cognitive impairment in participants with MCI were delayed memory (100%), language (75%), executive function (66.7%), attention (44%) and calculation (20.4%).

Conclusions

The impairment of memory, language and executive function is the primary characteristics in individuals with MCI. Individuals with MCI have similar characteristics with early stage Alzheimer's disease (AD). We should take preventive measures to improve or delay AD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

A founder mutation p.H701P identified as a major cause of SPG7 in Norway

BACKGROUND AND PURPOSE

SPG7 is one of the most common forms of autosomal recessive hereditary spastic paraplegia. The phenotype has been shown to be heterogeneous, varying from a complex spastic ataxia to pure spastic paraplegia or pure ataxia. The aim of this study was to clinically and genetically characterize patients with SPG7 in Norway.

METHODS

Six Norwegian families with a clinical diagnosis of hereditary spastic paraplegia were diagnosed with SPG7 through Sanger sequencing and whole-exome sequencing. Haplotypes were established to identify a possible founder mutation. All patients were thoroughly examined and the clinical and molecular findings are described.

RESULTS

The core phenotype was spastic paraparesis with ataxia, bladder disturbances and progressive external ophthalmoplegia. The variant p.H701P was identified in homozygous state in one family and in compound heterozygous state in three families. Haplotype analysis of seven surrounding single nucleotide polymorphisms supports that this variant resides on a founder haplotype. Four of the families were compound heterozygous for the previously well-described p.A510V variant.

CONCLUSION

SPG7 is a common subgroup of hereditary spinocerebellar disorders in Norway. The broad phenotype in the Norwegian SPG7 population illustrates the challenges with the traditional dichotomous classification of hereditary spinocerebellar disorders into hereditary spastic paraplegia or hereditary ataxia. A Norwegian founder mutation p.H701P was identified in four out of six families, making it a major cause of SPG7 in Norway.

Diagnostic accuracy of adenosine deaminase for tuberculous pericarditis: a meta-analysis

OBJECTIVE

Many studies suggest that adenosine deaminase is a marker for tuberculous pericarditis, while controversy exists as to its diagnostic utility. This study aims to summarize the overall diagnostic performance of adenosine deaminase for tuberculous pericarditis through a meta-analysis.

MATERIALS AND METHODS

Literatures published before May 2015 were searched in PubMed and EMBASE. The data were retrieved and the sensitivity, specificity, positive/negative likelihood ratio (PLR/NLR), diagnostic odds ratio (DOR) of adenosine deaminase for diagnosing tuberculous pericarditis were pooled, and the summary receiver operating characteristic (SROC) curves were used to examine the overall performance of adenosine deaminase.

RESULTS

In total, 11 studies with 938 subjects were included in the meta-analysis. The summary estimates of adenosine deaminase for diagnosing tuberculous pericarditis were listed as follows: sensitivity of 0.90 (95% CI: 0.86-0.93), specificity of 0.86 (95% CI: 0.83-0.89), PLR of 5.90 (95% CI: 4.46-7.82), NLR of 0.15 (95% CI: 0.09-0.26), and DOR of 42.55 (95% CI: 21.51-84.18). The area under the SROC curve was 0.92, and the Q value was 0.85. No publication bias was identified.

CONCLUSIONS

Adenosine deaminase is a valuable marker with both high sensitivity and specificity in the diagnosis of tuberculous pericarditis. Nevertheless, the results of adenosine deaminase assays should be interpreted in combination with other test results and clinical characteristics of patients.

Functional analyses of polymorphic variants of human terminal deoxynucleotidyl transferase

Human terminal deoxynucleotidyl transferase (hTdT) is a DNA polymerase that functions to generate diversity in the adaptive immune system. Here, we focus on the function of naturally occurring single-nucleotide polymorphisms (SNPs) of hTdT to evaluate their role in genetic-generated immune variation. The data demonstrate that the genetic variations generated by the hTdT SNPs will vary the human immune repertoire and thus its responses. Human TdT catalyzes template-independent addition of nucleotides (N-additions) during coding joint formation in V(D)J recombination. Its activity is crucial to the diversity of the antigen receptors of B and T lymphocytes. We used in vitro polymerase assays and in vivo human cell V(D)J recombination assays to evaluate the activity and the N-addition levels of six natural (SNP) variants of hTdT. In vitro, the variants differed from wild-type hTdT in polymerization ability with four having significantly lower activity. In vivo, the presence of TdT varied both the efficiency of recombination and N-addition, with two variants generating coding joints with significantly fewer N-additions. Although likely heterozygous, individuals possessing these genetic changes may have less diverse B- and T-cell receptors that would particularly effect individuals prone to adaptive immune disorders, including autoimmunity.