Objective To establish a new method for detection of β-glucuronidase (β-G) mRNA in human liver and kidney tissues. Methods β-G mRNA expression was detected by reverse transcription polymerase chain reaction(RT-PCR) in 10 cases of normal liver tissues, 10 cases of normal kidney tissues and 8 cases of hepatocellular carcinoma tissues. Results The expand products of β-G mRNA were expressed in liver and kidney tissues with similar size of 422 bp. The expression contents of β-G mRNA in liver and kidney normal tissues were different (1.71±0.32 vs 1.83±0.22) but without statistical significance (Pgt;0.05). However, the expression content of β-G mRNA in hepatocellular carcinoma tissues was 3.88±0.86， which was significantly higher (P＜0.01) than that in normal liver tissues. Conclusion β-G mRNA determination is feasible by checking β-G gene alignment in gene bank and designing draw matter in the tissue of liver and kidney. It may be very significant to explore the change of β-G mRNA in various tissues in studying of molecular mechanism.
【摘要】 目的 应用受试者工作特征曲线（receiver operating characteristic curve，ROC曲线）探讨α-L-岩藻糖苷酶（AFU）对恶性腹水和非结核良性腹水的诊断价值。 方法 2004年7月—2008年1月对213例诊断明确的良、恶性腹水（其中良性腹水117例、恶性腹水96例）AFU活性进行检测。采用ROC曲线评价AFU的诊断灵敏度、特异度、准确性、阳性预测值、阴性预测值、阳性似然比、阴性似然比及Youden指数，评价其诊断效率。 结果 恶性腹水组AFU水平（164.96±87.72） μmol/（L•h），良性腹水组（104.02±62.07） μmol/（L•h），两者比较差异有统计学意义（Plt;0.01）。AFU诊断恶性腹水的ROC 曲线下面积为0.754±0.034，最佳分界值101.95 μmol/（L•h）。以AFU≥101.95 μmol/（L•h）来预测恶性腹水，其诊断的灵敏度为82.3%，特异度为63.2%，准确性为72.8%、阳性预测值为65.3%、阴性预测值为83.1%、阳性似然比为2.23、阴性似然比为0.28及Youden指数为0.455。 结论 腹水AFU活性检测有助于恶性腹水和非结核良性腹水的鉴别诊断，是一个比较理想的实用指标，适合于基层医院的临床应用。【Abstract】 Objective To assess the value of α-L-fucosidase (AFU) levels with receiver operating characteristic curve (ROC curve) in the diagnosis of malignant and non-tuberculous benign ascites. Methods Ascitic AFU activity was measured in 213 patients (117 with benign ascites and 96 with malignant ascites) diagnosed with benign or malignant ascites. The diagnostic sensitivity (SEN), specificity (SPE), accuracy, positive predictive value (PV+), negative predictive value (PV-), positive likelihood ratio (LR+), negative likelihood ratio (LR-) and Youden index (YI) of AFU were assessed with receiver operating characteristic curve, and the diagnostic effectiveness of AFU was evaluated. Results The average level of AFU in the malignant group [(164.96±87.72) μmol/(L•h)] was significantly higher than that in the benign group [(104.02±62.07) μmol/(L•h)] (Plt;0.01). The area under the curve (AUC) of the ROC curve of AFU was 0.754±0.034 for malignant ascites diagnosis, and the optimal cut-off value was 101.95 μmol/(L•h). When an AFU level equal to or higher than 101.95 μmol/(L•h) was used to predict malignant ascites, the diagnostic sensitivity was 82.3%, specificity was 63.2%, accuracy was 72.8%, PV+ was 65.3%, PV- was 83.1%, LR+ was 2.23, LR- was 0.28 and YI was 0.455. Conclusion Detection of AFU activity in ascites is helpful to differentiate the diagnose between malignant and non-tuberculous benign ascites, which is a relatively ideal index to fit for clinical application of local hospitals.
Objective To investigate the etiology and the clinical features of obliterative bronchiolitis (OB). Methods Sixteen admitted patients were diagnosed as OB in Peking Union Medical College Hospital from Jan 1990 to May 2018. The case records were reviewed retrospectively. Results Twelve patients were female and 4 patients were male. The median age was 33.5 years (ranged from 17 to 55). The common symptoms included: exertional dyspnea in 15 patients (94%), cough in 10 patients (63%), phlegm production in 8 patients (50%). All of the 16 patients had associated conditions: paraneoplastic pemphigus in 6 patients (Castleman’s disease, lymphoproliferative disorder, inflammatory myofibroblastic tumor and follicular dendritic cell tumor respectively), chronic graft-versus-host disease after hematopoietic stem-cell transplantation in 3 patients, thymoma in 2 patients, Behcet’s disease, Sjögren syndrome, multiple myeloma, myasthenia gravis, and oral lichen planus in 1 patient respectively. The pulmonary function tests revealed severe or very severe obstructive ventilatory defect in all 16 patients. The CT scans showed slight ground-glass opacities in 10 patients, decreased attenuation of lung in 9 patients, mosaic attenuation in 8 patients, bronchiectasis in 7 patients, and air trapping in 3 patients. Conclusions OB is a clinical syndrome characterized by progressive airway obstruction, resulting from a variety of exposures or diseases. In most cases, diagnosis can be obtained on the basis of typical clinical, physiological, and radiological features, combined with OB-related diseases or exposures. Surgical lung biopsy can help diagnosis but risk-benefit should be taken into consideration seriously.